So after taking a super-shuttle all round San Francisco to save a couple of bucks on a cab, I’m back home and my mind is still trying to digest the last few days. It just won’t let me join my fiancee and the dog in a peaceful slumber. So I thought I’d channel my best Hunter S Thompson and give you my thoughts on HIMSS Gonzo style. You can pick and choose from this the way you like.

First off, I got to see about half Colin Powell’s talk. Man is he funny. I would never have believed it. Fantastic comic timing and facial expressions a la Eddy Izzard or Bill Cosby. Why they didn’t have him instead of Ballmer as the opening keynote I don’t know. He also said some very poignant things about immigrants, and the American spirit of generosity—which are clearly lost on several of his former Administration colleagues—and also was very clear about the debt to veterans. Unfortunately I don’t know if he raised the point or was challenged from the audience about one of the other notable speeches he gave. I mean the one when he went to the UN, was not funny and convinced enough Americans that there really were WMDs that several thousand more names will be on a  future war memorial. And it’s clear he knows that he was basically peddling discredited information at the time.

Distance—please can someone remind me next year to schedule meetings by booth number. Oracle gave me a pedometer late on the last day, but I walked miles too far. At least twice I scheduled back to backs in booths at least half a mile away from each other.

And then Intensity. There were at least 5 or 6 people I promised I’d meet up with that I just never got to (sorry David, Laura, Steve and a bunch of others). And you have to believe that the same was true for everyone. You’re at this for 12–14 hours a day, meeting maybe 3–4 new people an hour (sometimes more) trying to figure out who’s doing what to whom—just keeping it straight is really hard work. Harder still when someone you haven’t seen for 5 years takes you on a tour of Bourbon street that Hunter S Thompson himself would have been proud of (no mescaline, though). Thanks Adam (I think!)

Podcasts—I hope you like them and that it catches a little of my flavor. It’s way easier doing them than writing up notes, plus it gets you a much closer idea of what the interviewees are really doing. Transcriptions will be up soon.

THCB’s live blogging coverage of HIMSS 2007 New Orleans would not be possible without the generous assistance of the kind souls at CDW Healthcare. Take a moment to go check out their specials for physicians and other health care providers and you’ll help us continue to provide independent coverage and cutting edge discussion of the issues facing healthcare. We get credit for every person who clicks over, so please take twenty seconds and go visit their site. If you decide to place an order, tell them the Health Care Blog sent you — Matthew

Notoriety—I’m never going to be as well known as MrHISTalk in this crowd, especially as I was wearing the “I am MrHISTalk” badge, but there’s clearly a few people who are starting to read THCB, and recognizing it as something.  I think that if you read Tim Gee’s Medical Connectologist blog, and mine and MrHISTalk’s you get a great flavor. Shahid Shah was supposed to write the official HIMSS blog, but he never made it due to the weather, and the blog just looked like a bunch of information about the show logistics. Hopefully next year will be better.

Plus a couple of other blogs have been started that are worth a mention. Sun’s health care guy Jorge Schwarz bought me a fabulous lunch and told me that he has a real Sun healthcare blog too (like that other Schwartz guy who works there). Another is Doug Goldstein’s blog. Doug is an eFuturist (hey I’m a failed former futurist!) who’s actually out there promoting collaborations and electronic knowledge sharing with his health care clients. He has a scad of books out, and is a hell of a nice guy to boot. I’ve known him on and off for 10 years, but we randomly connected a few times at this HIMSS and it was a real pleasure. Finally MedSpehere founder and legal combatant Scott Shreeve is writing about Health2.0 on his blog as well as great HIMSS stories.

More on Health2.0 plans from me and others anon.

Speaking of Sun, at their lunch was the CIO of University of Alabama (and former school bus driver) Joan Hicks and some of her team. (NOTE: Her colleagues suggested that it’s only fair to point out that Joan was a school bus driver as a side job in college, and that that’s not the only qualification she has for her current job!) It’s not till you chat with a bunch of geeks who have to connect a gazillion systems at a ton of facilities before you realize that inter-operability is an internal more than an external health care problem. I spent some time trying to convince the Axolotl folks that was true too and that that’s what they were really doing. But they still think they’re a RHIO company.BTW their CEO Ray Scott is a really tall, really pointy headed Brit mathematician, who must be nuts—in that he had already made it good in the UK in the 1990s and still decided to get into health care. Still at least two gorgeous former employees came up to him and gave him huge hugs and kisses while I was chatting, which makes you think he must be a cool guy to work for—or maybe it’s just good to be the CEO. Thanks to Nicole Spencer for the wine I didn’t drink (leetle bit suffering from the night before)

Back on Gonzo trail. Apparently, if you have a ten week old kid you value crashing out early more than drinking with your old buddies on Bourbon street—you know who you are Mr Big Time drug database sales dude!

I’m feeling old—I met some really sharp young kids who are new to the business and know stuff. Matt Guidin at F&S is one, and opinionated and cynical to boot (we like those qualities at THCB). Jonathan Pearlstein at NORC is really young, but knows a whole lot more than I did when I was 22 (or 32). Watch for his thesis on EMRs (an undergrad thesis? Mine was on beer and soccer!) to come out in JAMIA sometime.

Eric Brown from Forrester, not so young but just as cynical as me about CDHP and just as willing to scarfe down fabulous chocolate desert at the Sun lunch that someone ordered but couldn’t stay for!

Another really nice guy I was delighted to meet—Reed Liggin at (now) RelayHealth. We’ve been emailing and chatting for a couple of years and I would never have met him other than via THCB. Rather more than I’d like to admit that I know about ePrescribing comes from Reed.

Not from Reed though, another little birdie told me that despite Surescripts certification process many vendors were having trouble getting their eRx transactions into pharmacy systems and a lot of re-keying in the pharmacy is still going on for allegedly ePrescriptions. Apparently there’s a NHIN report coming out next month that will put the cat amongst those pigeons. Plus what happens to RxHub if 1/3 of its owners are now a big pharmacy chain?  We shall see. But as an ePrescribing proponent, I’m worried. Can someone please reassure me?

However, my faith in being an eRx and EMR advocate was reinforced by Dr. Jim Morrow, who’s in the interview with Glen Tullman from Allscripts. Jim said straight out that before using the EMR, he may have thought he was a good doctor, but he was not. So by implication you cannot be a good doctor without using one. That’s a ballsy statement, but he made it with real conviction. (Go listen to the podcast—he’s not shy about it).

Speaking of Glenn Tullman, man I wish I had a tenth of his energy, poise, drive and diplomacy (not to mention money of course). I didn’t know that he’s an Obama supporter—I had him pegged as a liberal Republican (He told me he was a conservative Dem, not that there’s too much difference!). But if he’s not a major political figure within 10 years I’ll be very, very surprised. As I told him, Barack’s hoping to leave a Senate seat vacant in 2 years!

My favorite phrase of the conference? Medecision’s John Capobianco description of the job of his company— “making the unknown known”

Meanwhile, If you haven’t had a chance to sign up for THCB UPDATE yet, you really should. You’ll get a helpful reminder email from us a few times a week when important posts go up on the site. In the two and a half months since the service launched more than 700 950 people have signed up, thoroughly surprising me. I’ve pledged not to divulge any details about the people who sign up, but I can tell you that list reads a bit like a health care who’s who. Go on: It’s free. It’s useful. And people seem to like it. Go visit the sign up page.

Even despite the fact that they’re a client of mine (thanks Frances, Casey, Mike, Nick et al), the Cisco gang seem very happy. Could that be that now there are networks everywhere there’s more and more useful stuff to run over them? Just perhaps.

People on the rise—CMIOs everywhere. Holly Miller did such a great job creating the eCleveland Clinic online that the other guys in town (University Hospital) stole her to input their new system (which will be Eclipsys plus a new PHR/patient connectivity suite). But apparently when you’re a dignified CMIO having your exhibit hall companion threaten your vendor with firing them for not being able to provide you with a diet coke on instant command is apparently not encouraged! Hey if you’ve got clout use it, I say!

Talking of clout. You heard it hear first. IntercomponentWare’s LifeSensor PHR is terrible and doomed to failure. I mean, you may have really cool technology which works well, and very nice and smart people (not to mention the German government shoveling wads of cash at you) but if you can’t fix a simple prize drawing so that the world’s leading PHR interested blogger can win some Bose headphones, when there are only 5 people in the draw and he’s walked miles to be there and risked missing his flight to stay—what hope have you got in the rough and tumble world of health care IT?! (I can sense my opinion could be changed with only modest bribery! But a threat is a threat!)

Just kidding guys…

Talking of giveaways, while I never got to meet up with MrHISTalk to interview the Eclipsys booth babes as intended. I actually saw another booth down the other end giving away a plasma screen TV with some of the finest evidence of American medical science seen outside of a Playboy centerfold spread. Wish I could remember the company name.

Other quickies—Cool health2.0 type Emergency Department app from Puerto Rico called Sabiamed demoed by a lovely woman called Leslie who sat next to me on the plane on my way in from Miami. I fell asleep immediately as I had flown there from London and she had to punch me to get me to wake up to go to the restroom!

WebVMC has a Health Hero like telehealth application box that looked very interesting.

I don’t understand what NTR Global does (kinda like go-to-my-pc remote access/management but better) but Julie Weiner persuaded me that it was really important!

Random connection of the show. For 2 mins I was walking with a woman from Mobile, AL, who used to play soccer for Charlton Athletic ladies and the Univ of Alabama. She spotted my accent, and the story spilled out. I don’t know her name, but if you’re reading and you’re in San Francisco, my fiancee and I down load Match of the Day every week,  come by watch and take us for a ride in the mini!!

Second biggest mistake (after waking up Tuesday morning), was not organizing anyone to buy me dinner on Tuesday night. That used to be the night when I bought my clients dinner in my IFTF days, but these days especially as I was attending the show as a blogger on my own nickel, it’s what they call in football “a mental error.”

Worst giveaway—The AthenaHealth kids were fun, smart savvy and cute. And I never got past the front desk. No one over 30 anywhere, and all having a lot more fun than I did in grad school in my 20s. But they didn’t invite me to dinner on Tuesday night (But did Scott Shreeve—yes I’m bitter) and all they had as give-aways were white bouncy stress balls. As I said to them, “your giveaways suck, so I assume this means you think your products are pretty good!” Bonus points, though, if you can tell me which group in their backyard just went with someone else (Don’t worry guys there’s plenty for everyone…)

Biggest cojones—Bob Lorsch (see my interview with him below). A cancer survivor who’s put more than $7m of his own cash into building exactly the type of stand-alone, fax-it-in PHR that the “experts” say won’t fly. Of course not many of us experts have that to spend in the first place, which may define our expertise somewhat!

Worst forecast of the week—my taxi driver from Kenya leaving the convention center told me that we’d take 90 minutes and that I’d miss my plane. We were there in 25!

So that was the HIMSS that was for me. Let me know about your time in the comments, and feel free to abuse me back!