A Challenge to GE and AGFA

Yes, GE, and AGFA, I’m throwing down the gauntlet. It’s time. It’s really way past time I do this. 
Here’s some background. My group covers a number of hospitals. The two largest in our system use AGFA IMPAX 6.5. We also cover a very busy oncology clinic that uses Centricity 3.1. As you might imagine (and one of you claims to have a Healthymagination) patients bounce back and forth between the clinic and the hospital. Mr. Jones might have had is last three CT’s at the clinic, but now presents the the ED with intractable pain, and must of course be scanned STAT! Mrs. Smith’s tumor was discovered on scans at the hospital several months ago, and now is a patient at the clinic where her followup imaging will take place.
We deal with this scenario about ten times per day. The problem is, we don’t always know that the patient has had an old study, and more often than not, the oncologists call us, boldly telling us that we didn’t go where the patient had gone before, and would we please be so kind as to re-read the rather complex CT’s of the head, neck, chest, abdomen, pelvis, spine, and extremities now that we know about the comparison studies. This comparison has to be done on two different systems, which is a pain in the gluteus maximus even if I knew about the old study in the first place. It’s enough to make me drink…more than I already do. This is a patient-care issue, and a rather serious one at that.
Your mission, Vendors, should you decide to accept it (and I’ll bet you won’t…) is to solve this problem for me. WORK TOGETHER and create a solution. I need some form of Enterprise viewer to link or overlay or somehow mate the two systems, something that will find a patient’s exams performed at either site, and let me know, and more importantly, let me read them side by side as if they were done at the same institution.
I really don’t care which viewer ends up doing the job, although if GE wanted to do this right, they would leverage in the Centricity IntegradWeb client somehow. Otherwise, IMPAX 6 would probably be the next best choice. (Don’t anyone get a swelled head; I still don’t much like IMPAX OR Centricity 3.) 
This is not rocket science, boys and girls. Smaller companies like Intelerad and eRad, and bigger folk such as Carestream can do this. AGFA advertises their enterprise capability. So. It can be done. Now, figure out the way to do it for me.
Please?
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RIM-Shot: Lessons From BlackBerry Hill


RIM, Research-In-Motion, was once THE smartphone company. Anyone who was important, or wanted to look like they were, had a BlackBerry phone. I personally never succumbed, but my brother-in-law, who truly is important, by the way, had one of the early black-and-white models, which he used extensively. Many of my partners dabbled with the various RIM offerings, as I bemoaned in this post.

But today, RIM is on the road to extinction, a victim of the usual ignorance, arrogance, and hubris I often cite on these pages. The lessons to be learned are simple enough…know who your customers are, and give them what they want and/or need. It really is that simple.

Jonathan Geller wrote what may prove to be RIM’s obituary on BGR.com, dateline today. In his “exclusive look” Geller tells “. . . a story filled with attitude, cockiness, heated arguments among the executive team and Co-CEOs, and paranoia.” Sounds familiar.

Geller interviewed a number of former RIM execs for his piece, and the revelations are multitude:

Jim Balsillie and Mike Lazaridis are two irreplaceable leaders who were largely responsible for RIM’s success, our source continued. But as time progressed, Mike did not listen to the marketplace. This is obvious from the outside view, though the details surrounding why RIM is no longer a market leader — and why RIM will most likely not be able to regain its leadership position in the near future — are most interesting.

Let’s rewind a few years. Picture yourself sitting in an executive briefing at Research In Motion. You’d hear Mike Lazaridis unequivocally state time and time again that BlackBerry smartphones would never have MP3 players or cameras in them because it just does not make sense when the company’s primary customers were the government and enterprise. “BlackBerry smartphones will never have cameras because the No. 1 customer of ours is the U.S. government,” Mike Lazaridis would say in meetings. “There will never be a BlackBerry with an MP3 player or camera.”

The fact is, that RIM didn’t only miss the boat in terms of product features and device trends as we now know, but the underpinnings of the company’s consumer failure began all the way back in 2005 with bold statements like these, combined with a lack of research and development in numerous key areas. . .

The three-year roadmap for RIM products focused on refining the technology in phones had already been released, rather than looking at where to add major new componentry or trying to identify or even shape future trends.

“When you hear Mike talk about the latest and greatest, it’s been the same thing for ten years: security, battery performance, and network performance. RIM has positioned battery life and network performance for years. People are not concerned with iPhone battery life,” one source told me. Network performance, to Mike, trumps any innovation a device like the iPhone offers. “Mike is convinced people won’t buy an iPhone because battery life isn’t as good as a BlackBerry,” a different source said. Mike apparently is in disbelief that people can use over 15GB of data on their iPhone and Android devices, and he feels that people will buy smartphones based on network efficiency, even though carriers with tiered data plans in developed markets love customers who use monstrous amounts of data.

Yup. The surest way to alienate your customers is to tell them what they want, rather than listen. The next-surest mistake is to compound the first mistake by doubling down on a product that no one liked in the first place.

Of course, you need to identify just whom your customers really are:

While RIM has always viewed carriers as customers rather than end users, carriers have long been trying to find a different partner that doesn’t charge network fees. 

RIM saw the gravy-train as hooked to the carriers, and not to the folks like me that would actually have to use their devices and services. Bad move, at least in the end.

Speaking of mistakes, it is generally bad form to promise a feature and then renege or require some additional part or fee to make said feature function:

. . .Jim Balsillie told the carriers at the 11th hour that the PlayBook wouldn’t have native email and would require the Bridge app in order to receive emails and provide calendar functions. “RIM is notorious for dropping these bombshells at the 11th hour on the carriers, and the PlayBook not having native email was a shock to the carriers.” They were all expecting a BlackBerry with a bigger screen. RIM was hoping to blow through the 500,000 units and have carriers take orders for millions of additional PlayBooks, but that has not happened yet. Mike Lazaridis looks at it as, why aren’t people buying this tablet when it has the most powerful engine with respect to multitasking, and supports Flash? But consumers have spoken pretty loudly a number of times, and Mike unfortunately leads the product side and continues to miss the mark with the masses, a former RIM executive told me. “I don’t even see anyone in Waterloo walking around with a PlayBook that doesn’t work for RIM,” another former RIM employee said.

I think my point is pretty clear. What is happening to RIM is not unexpected, at least by those on the outside. Here was a company that had “lightning in a bottle”; they should have been the premier smart-phone maker on the planet. BUT THEY DIDN’T LISTEN TO THEIR CUSTOMERS. RIM’s masters had no clue or care about what the great unwashed masses wanted in a smart-phone. They wanted to dictate what was important and what wasn’t. They wanted to tell us…because they thought they knew better than their customers what was needed. Throw in the disconnect between the perceived customer and the actual customer, and you have the recipe for the slow-research-in-motion train-wreck we are now witnessing.

The lesson is complete when one substitutes the name of a PACS vendor and their product for RIM and BlackBerry, respectively.

Did someone say Waterloo?

It’s Heart-Attack Friday

Dalai’s note: A few years ago, our most senior partner was stricken with an MI on a Friday after working a twelve-day shift including weekend call. Today is my 24th day of work with only one day off in the middle, due to some scheduling problems in the front office. Thus, for me, this is a triple “Heart Attack Friday.” With some luck, I’ll make it past midnight tonight….

With apologies to Jimmy Buffett and Alan Jackson….

Dalai:

My head is hot and my ST segments are depressed

And so am I

Angina passes like molasses in wintertime

But it’s July

Got more pain by the hour and older by the minute

Damn call days just pushed me over the limit

I’d like it to be indigestion

But think I’ll just call it MI

Chorus:

Draw me up some TPA

Get that needle parked before my heart infarcts

I’ve only been at work for twenty five days

It’s Heart-Attack Friday

Dalai:

This cardiac cath is going to take all day

And half the night

Tomorrow morning I know there’ll be hell to pay

Hey, but that’s all right

I ain’t had much time off in this part of the year

My cardiac event is gonna start right here

If the phone’s for me

You can tell ’em I’ve just gone off call PERMANENTLY

Chorus:

Draw me up some TPA

Get that needle parked before my heart infarcts

I’ve only been at work for three weeks and four days

It’s Heart-Attack Friday

Dalai:

I could have retired young

And had some fun, and always be in bed before 2

At a moment like this, I can’t help but wonder

What would Jimmy Buffett do?

Jimmy Buffett:

Funny you should ask, Dalai….

I’d say,

“Draw him up some TPA

Get that needle parked before his heart infarcts

He’s only been at work for three weeks and four days

It’s Heart-Attack Friday

Yup, Draw him up some TPA

Get that needle parked before his heart infarcts

He’s only been at work for three weeks and four days

It’s Heart-Attack Friday”

He don’t care

And I don’t care

It’s Heart-Attack Friday

Hey, how’s his EKG?

What hospital is he in?

Dalai:

It doesn’t matter

It’s Heart-Attack Friday

Jimmy:

It’s always Heart-Attack Friday when you’re on call

Dalai:

I heard that

Jimmy:

You’ve been there haven’t you?

Dalai

Not yet, Jimmy

Jimmy:

I’ve seen your name on the chart

Dalai:

I need to go to Margaritaville, STAT!

Jimmy:

All right. That’s good

Smother Down Under

I haven’t heard much from my friends in Western Australia lately. When I asked about their languishing PACS, I was told, “Not much new. Nothing to see here.” This, of course, piqued my curiosity, but no one had much else to say about PACS, or much of anything else beyond the lovely weather there on the coast of the Indian Ocean.

Nature abhors a vacuum, so it is said, and I sense a vacuum of information. Trolling the internet was not particularly revealing, although I did stumble upon a few tidbits on the official website of the Department of Health from the Government of Western Australia. I have to say that the website is very nicely done, and it is at least a little cleaner and more user-friendly than ours, for example.

Within the WA site, I found the following passages, which strike me as a bit odd. First, we have the “Policy on Use of Official Information and Public Comment” which was released June 8, 2011:

PURPOSE

WA Health employees are not permitted to use official information obtained through the course of their employment to provide public comment or communicate in writing or online without the express authorisation of their Chief Executive Officer. Public comment includes, but is not limited to, verbal comments to the media, written communication such as letters to the media and online communication by email, blogging and posts via social media sites. Unauthorised disclosure of official information is a breach of an employee’s duty of fidelity and good faith which will result in disciplinary action and in some cases termination.

SCOPE

This Policy applies to all employees within WA Health entities including:

  • Department of Health
  • Metropolitan Health Service
  • WA Country Health Service

POLICY

This Policy covers all verbal, written and online communication by employees using official information obtained through the course of their employment. This Policy applies to communication during and outside of work hours.

Part 2 Division 1 Section 9(b) of the Western Australian Public Sector Management Act 1994 (as amended) (the PSM Act) states that all employees of public sector bodies:

“Are to act with integrity in the performance of official duties and are to be scrupulous in the use of official information, equipment and facilities.”
Accordingly, WA Health employees are not to:

  • Release any information made available to them in the course of their duties, or in response to a statutory or legally empowered enquiry, without proper authority.
  • Make use of any information gained in the course of their employment for their personal benefit or gain.
  • Make any statements on official Departmental, Area Health Service or Ministerial letterhead or the internet that conflicts with official policy or legal and administrative precedents.

Further, the PSM Act, Administrative Instruction 278 – Media & Public Communications states:
“Selected public servants may be called on, as part of their official duties, to explain or provide information to the media or the general public on their agencies’ policies and activities. Chief Executive Officers will determine which officers shall be authorised to make public comment.

  1. Those public servants who are empowered to make public comment should confine themselves to providing such information as is necessary to explain government policy or to provide factual, explanatory and background material pertinent to the question at hand.
  1. In doing so, they should avoid making any comment which could undermine public confidence or disrupt the everyday administration of either the Public Service or the Government of the day. To this end, they should:
  • Not give their personal views on matters of government policy or administration, or on advice made to government.
  • Not speculate on future policy directions.
  • Not publicly criticise any political party, its actions or its policies.
  • Not prolong discussion or debate on an issue once a decision has been made, or a policy adopted.

Accordingly, WA Health employees are not permitted to:

  • Disclose official information obtained through the course of their employment to the public through verbal comments to the media, or by written communication such as letters to the media, or online communication by emails, blogging and posts via social media sites, without the express authorisation of the Chief Executive Officer;
  • Disclose official information obtained through the course of their employment to engage in verbal, written or online communication to disparage, discriminate and/or defame WA Health and/or colleagues;
  • Compromise or be perceived to compromise the employee’s ability to carry out his or her duties including the duty of fidelity and good faith.

In addition:

  • When delivering conference papers or discussing issues related to WA Health or on their professional, scientific or technical findings, it is acceptable for staff to use official information that is not confidential. However, in doing so, employees must issue public disclaimers stating that the views are their own and are not necessarily those of the government of the day or WA Health.
  • Relevant Public Relations / Public Affairs areas within the Department of Health or Area Health Services are to be advised of any conference papers or presentations likely to be contentious or which may attract media attention.

CONTACT WITH THE MEDIA:
Generally, public comment to the media is made through the relevant Department of Health or Area Health Service Public Relations / Public Affairs areas. The following should be noted:

  • WA Health employees are not to comment or provide information to the media without proper prior authorisation.
  • Some WA Health employees may be called upon by the Public Relations / Public Affairs area to explain or provide information to the media or to the public on the policies and activities of government.

OTHER POLICY AND LEGISLATIVE OBLIGATIONS:
Prohibited Use of Official Information and Public Comment may also be in contravention of:

  • WA Health Code of Conduct;
  • WA Public Sector Code of Ethics;
  • Public Sector Management Act 1994;
  • WA Health policies, including the Prevention of Bullying, Harassment and Discrimination in the Workplace Policy, Use of Social Media; and
  • Health Services policies, including Confidentiality policies.

…..
Breaches
Any staff member who breaches the provisions of this Policy will be committing an act of misconduct and may be subject to the procedures outlined in the WA Health Misconduct and Discipline Policy, the Public Sector Management Act 1994 or to other action or provisions relevant to the management of conduct.
Kim Snowball
DIRECTOR GENERALDEPARTMENT OF HEALTH WA

And here’s another, the “Policy on Use of Social Media:”

PURPOSE

The purpose of this policy is to ensure that employees do not engage in online communication that is disparaging and/or discriminatory towards the WA Health and/or colleagues. Communication may include, but is not limited to emails, blogging and posts via social media sites such as Facebook, MySpace, Twitter, YouTube and Flickr. Disparaging communication includes negative, adverse, inappropriate, offensive, discriminatory and abusive blogs/posts that criticises WA Health and/or colleagues in a public way.
The use of online communication via social media to post or blog disparaging comments about WA Health and/or colleagues is a breach of an employee’s duty of fidelity and good faith which will result in disciplinary action and in some cases termination of employment.

SCOPE

This policy applies to all staff within WA Health entities including:

  • Department of Health
  • Metropolitan Health Service
  • WA Country Health Service

POLICY

This policy covers all online communication via social media sites made by an employee, whether during work hours on a work computer, or during work hours on a personal electronic device, or outside work hours on a personal electronic device. Online communication via social media sites that is prohibited includes, but is not limited to, communication that:

  • Mentions the WA Health by name, its business operations or confidential information;
  • Is defamatory;
  • May be construed as discriminatory or bullying;
  • Bullies, harasses, discriminates or vilifies work colleagues;
  • Includes abusive status updates and/or blogs that criticise work colleagues, offends others and/or breaches their employment obligations in public ways; and
  • Publicises or comments on workplace disputes.

Prohibited online communication via social media sites may also be in contravention of:

  • WA Health Code of Conduct;
  • WA Public Sector Code of Ethics;
  • Public Sector Management Act 1994;
  • WA Health policies, including the Prevention of Bullying, Harassment and Discrimination in the Workplace Policy, Use of Official Information and Public Comment; and
  • Health Services policies, including Confidentiality policies.

An employee that engages in online communication to make disparaging comments about the Department, management, colleagues and/or patients will be in breach of their duty of fidelity and good faith. Such conduct will be found to be misconduct which will result in disciplinary proceedings and may lead to termination of employment.
Any queries regarding this directive can be sent to industrial.relations@health.wa.gov.au.

Kim Snowball
DIRECTOR GENERAL
DEPARTMENT OF HEALTH WA

Well, I think the message is pretty clear, and I have to wonder if my foray into investigative journalism from last year had anything to do with these policy revisions. Anyone taking bets?

My first thought when reading these policies, which are posted right there on the internet for all to see, was, “What about Free Speech????” As it turns out, Oz has some different rules about that than we do here in the States. From the Wiki:

Australia does not have explicit freedom of speech in any constitutional or statutory declaration of rights, with the exception of political speech which is protected from criminal prosecution at common law per Australian Capital Television Pty Ltd v Commonwealth.

In 1992 the High Court of Australia judged in the case of Australian Capital Television Pty Ltd v Commonwealth that the Australian Constitution, by providing for a system of representative and responsible government, implied the protection of political communication as an essential element of that system. This freedom of political communication is not a broad freedom of speech as in other countries, but rather a freedom whose purpose is only to protect political free speech. This freedom of political free speech is a shield against government prosecution, not a shield against private prosecution (civil law). It is also less a causal mechanism in itself, rather than simply a boundary which can be adjudged to be breached. Despite the court’s ruling, however, not all political speech appears to be protected in Australia and several laws criminalise forms of speech that would be protected in other democratic countries such as the United States.

In other words, Western Australia’s policies are perfectly legitimate and enforceable, although rather surprising for a nation which prides itself on being cantankerous and disrespecting authority. It therefore seems unlikely that I will ever hear much more about PACS or any other trouble that might possibly disparage the WA government.

Fortunately, there seems to be no proviso to punish the recipient of such information, especially a foreign national such as myself, so hopefully, I’m still allowed to travel to Australia.  I would be devastated if they took that privilege away.

In the meantime, I guess it’s up to Crikey to find out if anything is going down Down Under.