Merge CEO Leaves To Run Tribune Publishing

Is it me? Is it something I said?

I keep having to break in new CEO’s at Merge Healthcare, and AMICAS before that.
Back in the AMICAS days, I apparently chased out Hamid Tabatabaie. Then Peter McClennen. Then Steve Kahane. Then Merge came on board, and I thought I had a keeper with Justin Dearborn. But alas, he too has seen the light.
I’m kidding, of course, about me having much of anything to do with anything at Merge, but it is true that Justin Dearborn is leaving Merge to become the CEO of Tribune Publishing. From the Chicago Tribune, one of the papers TP manages, comes this article, dateline yesterday:

Three weeks after welcoming Michael Ferro as the largest shareholder and nonexecutive chairman of Tribune Publishing, Jack Griffin is out as CEO.

Griffin, who has guided Tribune Publishing since its August 2014 spinoff, has been replaced by technology executive and longtime Ferro associate Justin Dearborn, the Chicago-based newspaper company confirmed Tuesday.

Dearborn, 46, had been CEO of Merge Healthcare, a Ferro-controlled medical technology company that was acquired by IBM in October.

“Although this is a different medium than my last technology company, it has the same challenge on how to create the highest value for our content,” Dearborn said in the news release.

Michael Ferro, as my readers know, bought the scraps of Merge years ago, and then purchased AMICAS to give the reborn company a working PACS.

Tribune Publishing owns the Chicago Tribune, Los Angeles Times and other major newspapers. When Ferro’s acquisition was announced, Griffin called Ferro “a tremendous admirer of our brands at the Tribune … so it’s a winning combination for our company.”

{snip}

Dearborn, who has no media experience, takes the helm of the legacy newspaper company as it struggles to reverse years of industrywide revenue declines and transition to a digital-first medium. He has a long track record with Ferro, the two having worked together on Internet software company Click Commerce, investment firm Merrick Ventures and most recently Merge Healthcare, a Chicago-based medical software company that was sold to IBM for about $1 billion, including the assumption of nearly $198 million in debt, according to Dealogic.

In June 2008, Merrick Ventures bought a controlling stake in Merge, which had been reeling from an earlier accounting fraud scandal, for $20 million, including a $15 million loan. Dearborn was installed as Merge CEO the following month.

Although Merge didn’t turn a yearly profit under Ferro’s and Dearborn’s leadership, the development of an artificial intelligence initiative to analyze medical diagnostic records caught IBM’s eye last year, leading to the sale of the company.

Merrick’s 23.5 percent stake in Merge was valued at nearly $190 million in the IBM transaction.

Congratulations to Mr. Dearborn. He is incredibly capable, and I’m sure Tribune will thrive under his leadership. Perhaps with his connections, we will see Watson trained to read the various newspapers and provide commentary. That would be about the only column I would pay to read.

In the meantime, I’m waiting to find out something very important to us customers…Who will take the helm at Merge?

via Blogger http://ift.tt/1VFaYGl February 24, 2016 at 03:10PM

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My New Workstation

I sit on my backside most of the day, staring at a workstation monitor. At some sites, I have the Herman Miller Aeron chair, which is OK, but there has to be a better way to sit and think and interpret, and whatever else it is I do all day.
And here it is:

The Altwork Company has come up with a better way, a “new way to work,” the Altwork Station. Look at the pictures and watch the video, and I think you’ll agree, it has got to be better than what most of us do now.

This next step in workspace evolution is fairly reasonable as such things go…

As an early adopter, you’ll be one of the first people on Earth to have a workstation that works with you.

The list price for an Altwork Station is $5,900, but for our early adopters, we’re offering significant discounts.

Our early discount program will provide a forum for you to get to know us, and for us to get to know you as we build, deliver, and support a workstation that will change the relationship between you and your work.

There are two options for Altwork early-adopter discount customers:

Buy Now – $4,900 or $3,900

Signature Altwork Station – $4,900 includes:

Lock-in early adopter discount of $1,000
Choose from 10 custom upholstery colors, 3 frame colors, 4 desk and accent colors
Engraved commemorative plate with unique serial number
Priority manufacturing and shipping (you’ll be the first on your block)
Limited quantity available
Price does not include shipping

Altwork Station – $3,900 includes:

Lock-in early adopter discount of $2,000
Choose from 2 pre-configured color palettes
Priority manufacturing and shipping (you’ll be the second coolest kid on your block after Signature series, which is still pretty cool)
Limited quantity available
Price does not include shipping

I think I could do without the Signature Version. On second thought, why not go all the way?

I think my backside is worth it!

via Blogger http://ift.tt/1Rhf9Hd February 21, 2016 at 09:46PM

Brother, Can You Spare A Dime ($0.10 CAD) For A PET?

The Canadian healthcare system has been touted as the most wonderful thing since sliced bread, the epitome of the Single-Payer model, the Way It Should Be Done, the ultimate, logical manifestation of where we are headed. The Affordable Obama Care Act is, of course, just a brief bus-stop on the highway to Canada.

But wait just a moment, eh? All is not perfect in the land of the frozen. How many Americans (or Saudis or potentates of various small nations) go to Canada for esoteric, life-saving surgery? Conversely, how many Canadians cross the border (no wall as yet) for their care? (Answer: Depending on the source and the year, upwards of 50,000.) Yes, drugs are cheaper Up North, because the Canadian government artificially caps the prices, forcing us hosers in the U.S. to pay the difference.

It seems that some procedures might require a wait. A long wait. In fact, wait times are so much a part of the Canadian healthcare culture that there are official websites devoted to telling our Canuck friends just how long they’ll have to wait. Here’s the link from the Ontario Ministry of Health and Long Term Care, for example.

If you should happen to check Diagnostic Scans, you’ll be able to chose CT or MRI. Let’s pick MRI, and then select a nice town in Ontario called Sudbury, which yields:

Diagnostic Scans
Magnetic Resonance Imaging (MRI)Target:28 days
[Oct-Nov-Dec15]
Hospital Name
Location
Wait time (days)
Provincial Wait Time
(9 out of 10 patients complete their procedures in this time)
101
Hôpital régional de Sudbury Regional Hospital Sudbury 83
Northeast Mental Health Centre Sudbury NR/NS

Can you imagine the b*tching and moaning you would hear if you told an American he/she would have to wait over three months for an MRI? Yanks get upset if they can’t get their scan the day it’s ordered.

The site above doesn’t mention PET/CT scans, and there’s a reason for that. There are 12 (give or take) PET/CT scanners in all of Ontario, and utilization is, well, a bit different than we see here in the States:

The volume and percentage of PET/CT scanning across the province in 2013 remained steady in relation to the previous year (Figures 2 and 3). The number of completed oncology-related PET/CT scans per million population increased from 510 in 2011 to 671 in 2013, which may be a result of an increase in the population of the province and of rising cancer incidence rates (Figure 2). The increase also might be attributed to some head and neck cancers becoming part of the insured indications for PET/CT scans in April 2012.

That would be just under 700 PET/CT scans per million, yes? In the US, that figure is 5,000 per million population. In fact, here is a breakdown of scanner distribution and utilization in some of my favorite countries, although some of the numbers are a little older:

Which brings us to the PET/CT status of Sudbury, Ontario, which is either heartbreaking or heartwarming, depending on your point of view. It seems that the citizens of Sudbury themselves have been asked to pay for the regional scanner themselves. The following quotes are all from the Canadian Broadcast Company (CBC):

Sudburians have spent years trying to raise millions of dollars to buy its hospital a PET scanner. A Positron Emission Tomography (PET) machine uses a type of sugar to detect cancer, cardiac issues and even dementia.

The Ministry of Health and Long-Term Care has told the city it’s up to residents to raise the money needed to buy the region’s first machine, which is estimated to cost as much as $5 million dollars.

The machines are cheaper than that, but you have to have a shielded room in which to put them, and a great deal of additional infrastructure, so the price is probably not far off the mark. Or the CAD. But this sure sounds unusual. Making the patients pay for the scanner? I knew this sounded familiar, and in fact, another Ontario hospital, Seaforth Community in East Huron, had to hold a radiothon to pay for its PACS in 2007. Again, the money just isn’t there for a critical service. Well, we assume the money just isn’t there, eh?

A Sudbury doctor says his community’s struggle to get an important piece of cancer detection equipment is another example of the provincial government’s attempt to block the technology…

The Ministry of Health and Long-Term Care has told the city it’s up to residents to raise the money needed to buy the region’s first machine, which is estimated to cost as much as $5 million dollars.

Dr. Dave Webster says asking the community to foot 100 per cent of the bill is a way for the ministry to purposefully slow down the introduction of PET technology across Ontario.

“It’s quite simple. They don’t want to pay for it,” he said.

Webster, a nuclear medicine doctor who has fought for decades to bring more PET scans to the province, said the machine can accurately detect cancers that MRI and CT scans cannot.

“You have patients that would have survived their cancer had they had a PET scan at an appropriate time,” he said. “And similarly, there are people that are told therapy is not possible and the PET scan shows they are.”

“People in Ontario are more likely to die simply because they will not have access to what has simply been the standard of care on following up with cancer patients for more than a decade,” he said.

Windsor doctor Kevin Tracey was a founding member of a ministry-backed committee set up more than 15 years ago to bring PET technology to Ontario.

He said he resigned in protest because the government was purposefully slowing down access to the scan.

“Basically, we’re holding the number of patients down that need scans done. I’m sure there’s monetary reasons why that’s done,” he said.

Tracey said Ontario is doing fewer PET scans than just about anywhere in the western world.

Ontario performs 11,000 PET scans per year, according to Cancer Care Ontario, while Quebec performs nearly four times that number, more than 40,000 scans annually, with a much smaller population.

There is a very personal facet to this particular PET tale:

(The decision to fund PET operations) was an early Christmas present for the family of Sam Bruno, a man who spent the final years of his life trying to bring a PET scanner to Sudbury…

Since his death five years ago, Bruno’s family has spent years raising money for a PET scanner in Sudbury — and on Tuesday were one big step closer to realizing their dream.

The province has agreed to spend $1.6 million each year to operate the machine.

The community needs to raise $2 million more to make it a reality. A total of $1 million has been raised so far.

Hoskins said he hopes his ministry’s funding commitment will be a shot in the arm to fundraising efforts.

Having a PET scanner in Sudbury to service northeastern Ontario patients means people like Bruno will no longer have to travel to Toronto for tests.

You might think Sudbury is too small for a PET/CT. You would be wrong. Sudbury has over 160,000 citizens, not much smaller than my little town in the Deep South. And we have three PET/CT’s here. Sudbury has an-otherwise state-of-the-art oncology facility, lacking only PET/CT.

“We should have had it a long time ago,” said Wayne Tonelli, co-founder and president of the Miners for Cancer charity. “We have a world-class facility here in Sudbury with our cancer centre. Let’s get some world-class equipment here.”

I’m assuming the “Miners for Cancer” actually favor a cure for cancer.

Editorial time. Forgive the somewhat jingoistic language to follow.

The healthcare here in the United States is good. Really, really good. People who can afford to do so come HERE to be diagnosed and treated. Those who can afford to come HERE do NOT go to Canada. Or Germany. Or Switzerland. Or Sweden. Or India. Or Anywhere Else. I’m not saying I contribute much, if anything, to it, but the best medicine in the world is practiced in the United States.   Now I don’t think our system is perfect, and I have called for massive reforms, dumping Obamacare, Medicare, Medicaid, and revamping the whole thing including a huge revision of the laws governing the Third-Party Payers, our beloved insurance companies. Ours is a dysfunctional system and it has to be revised. But even with its blemishes, ours produces some of the best medicine in the world.

And yet, in our inexorable march toward Socialism, led by demagogues who would have us trade everything that makes America America for “free stuff”, American health care stands to be crippled in the process of making it “free”. And by the way, nothing is “free”. Someone has to pay for the “free stuff”.

We need to look at the case of Sudbury’s PET/CT and understand the implications. There isn’t enough money in Ontario to provide “free” PET/CT for Sudbury, and in fact, funds for this life-saving technology are limited province-wide. Thus, the fine people of Sudbury will have to fund the purchase themselves. That they are willing to do so to help their fellow citizens is the heartwarming part of this story. The heartbreaking aspect is that they have to do so. I see this as a huge crack in the perfect facade of Canada’s single payer system. It FAILED the people of Sudbury. And it fails the people of Ontario, and indeed all of Canada by limiting resources and thus rationing their care.

In response to my East Huron Radiothon post of 2007, a (probably former) reader commented:

As a personal friend, and former patient of Dr. (mentioned in article), I need to comment!

Our healthcare is NOT free, but our taxes allow us wonderful healthcare, and an above-average level of access to all kinds of medical tests etc. What we need, we get. It’s easy to stand in the U.S. and throw stones, but around here (Southern Ontario) we decide how many kids to have by deciding how many kids we WANT to have, rather than by how many our insurance (or lack thereof) will pay for! We take our kids to the doctor when they NEED to go, not when we have enough money to pay a co-pay!

My son was special-needs…yes, born at Seaforth Hospital. He received first-rate care, with swift and appropriate transport to Children’s Hospital. On day 3, I heard a PCCU nurse say of my son “Well, there’s a million dollar boy!”, meaning his cost of care had already topped the million dollar mark. Had my husband and I NOT lived in Canada, our grandchildren would still be paying off the cost of that hospital stay…let alone the other numerous hospital stays our son had through his life.

We don’t have a problem donating for good causes…we’re neighbours. That’s what good neighbours, and good citizens do.

It’s hard to argue with this statement, but read it again. Maybe twice more. “What we need, we get.” Sounds a little bit too close to “From Each According to Their Abilities, to Each According to Their Needs”. But then maybe I’m biased.

The profit motive has brought an overabundance of expensive CT, MRI, and PET/CT scanners to the United States, with the inherent likelihood of over utilization. Contrast this to the neighbourly situation in Ontario which requires the citizens themselves to raise money for life-saving technology that the government, even using the generously given tax-dollars (CAD) cannot provide. Better to over-utilize, or better that “. . .(p)eople in Ontario are more likely to die simply because they will not have access to what has simply been the standard of care on following up with cancer patients for more than a decade…”? You tell me.

“Free stuff” can have a very high price-tag.

via Blogger http://ift.tt/24hiY6l February 20, 2016 at 08:18AM

Hostage Data

I was first alerted to the situation by my friend Stacey, who directed me to the story on the Daily Kos. I tend to avoid that site like the plague, but I had to read this story.  Fortunately, the author, “Medical Quack”, has the information on his own blog, and the story has since been picked up by many other news outlets, including Fox.

Here are the facts from Medical Quack:

A Southern California hospital was a victim of a cyber attack, interfering with day-to-day operations, the hospital’s president and CEO said.

Staff at Hollywood Presbyterian Medical Center began noticing “significant IT issues and declared an internal emergency” on Friday, said hospital President and CEO Allen Stefanek.

A doctor who did not want to be identified said the system was hacked and was being held for ransom.

There is no information that any patient or employee information was compromised, but the hospital called in computer forensics experts, and the FBI and the LAPD to investigate.

The hospital’s emergency room have been sporadically impacted since Friday, Stefanek said.

The unnamed doctor said that departments are communicating by jammed fax lines because they have no email and that medical office staff does not have access to email.

9000 bitcoins is the price demanded to give the hospital back the “key” codes to open the system back up. 911 patients are being diverted to other hospitals.

The hospital seems to be keeping it pretty quiet and I guess really what else can they do as paper back up files come out as they always do in times when the EHR goes down.

This disruption is raising havoc with getting access to all the patient information needed at times. Radiation and Oncology has been shut down and they are not allowed to turn on their computers.

The Daily Kos quoted all this directly, but revealed the EMR vendor in the title of the piece:

Hollywood Presbyterian Medical Center McKesson EHR Hacked And Hospital Data Being Held for Ransom..

If you prefer a little less innuendo and speculation, here’s the FoxNews version:

A Los Angeles hospital paid a ransom of nearly $17,000 in bitcoins to hackers who infiltrated and disabled its computer network because paying was in the best interest of the hospital and most efficient way to solve the problem, the medical center’s chief executive said Wednesday.

Hollywood Presbyterian Medical Center CEO Allen Stefanek said the hackers demanded a ransom of 40 bitcoins, currently worth $16,664. The FBI is investigating the attack, which began on Feb. 5.

Authorities said this kind of attack is called “ransomware,” where hackers encrypt a computer network’s data to hold it “hostage,” providing a digital decryption key to unlock it for a price.

“The quickest and most efficient way to restore our systems and administrative functions was to pay the ransom and obtain the decryption key,” Stefanek said. “In the best interest of restoring normal operations, we did this.”

This implications of this sad situation are staggering. Some little twerps, most likely operating from outside of the United States, brought a hospital to its knees, forcing it to pay a ransom to continue operations (and surgeries too, we assume.) I’ll bet this has happened before, but hasn’t been reported by the IT and IT Security folks affected. I’d be embarrassed too. That the little miscreant involved settled for “only” $17,000 in untraceable Bitcoins suggests that he is but a lowly amateur. And that is even more frightening. If some high-school kid in an Internet cafe can do this, what could government-backed (and you know which governments I mean) hackers accomplish? What could ISIS-owned hackers do to us?

Everything we associate with daily life is hooked into the Internet somehow. Communications, entertainment, health-care, power plants, missile launchers…pretty much everything. Now I’m a firm believer in individuals, companies, enterprises, etc., taking reasonable precautions against hackers. Cybersecurity is big business and rightly so. But the relatively minor incident in California is a HUGE wake-up call, not that we really need it. Hacking our infrastructure via the ‘Net is a huge national security issue. We are in just as much danger from the hackers as we are from the crazy kid in North Korea with the bad haircut and shiny new intercontinental ballistic missiles. With a few key-strokes, a hospital was taken down (proving Dalai’s First Law in the process: PACS IS the Radiology Department). With a few more, a nuclear power plant could shut down. Or melt down. That’s no exaggeration.

We the People need to be protected from this sort of thing, and it is our government’s job to do so. Yes, they are trying, half-heartedly, without adequate time, money, or effort, to fight against a hidden enemy. I’ve been told by execs from phone companies that the telemarketers hacking and spoofing their systems have better software and better technology than we do. If they can bollux our phones, if we can’t defend our communications networks, we’re sunk.

Our administration, in its infinite wisdom, will be turning over control of the Internet to the UN. Great. Most governments of Third World nations, not to mention quite a few Second World countries,  ISIS, and other nice folks, either ignore illegal Internet activity, or actively encourage and participate in it. And there are no consequences from us. Zero.

How to solve this? Somehow we have to let our “friends” overseas know that we won’t tolerate this anymore. Do we have to sever the Internet backbones? I hope not but unless the rest of the world will police their own vermin, we will have to do it for them, or at least isolate ourselves from the infection. There need to be sanctions, fines, treaty revocations, and I don’t know what else to put a stop to this.

As for home-grown United States-based hackers, we have to institute some VERY severe punishments. Up to and including capital punishment for anyone whose illicit activity leads to the death of innocents. And we have to have a moon-shot level program to boost our technology to surpass that of the criminals.

I’m mad as Hell about this. Our government has failed to protect its citizens, and that has to change.

NOW.

via Blogger http://ift.tt/1XzNQdK February 18, 2016 at 09:05AM

The Measure Of A Company

The measure of a man cannot be whether he ever makes mistakes, because he will make mistakes. It’s what he does in response to his mistakes. The same is true of companies. We have to apologize, we have to fix the problem, and we have to learn from our mistakes.

Wil Shipley

Software, being written by humans (until Watson gets the hang of it, I suppose) is going to contain errors. When the program has something to do with the medical field, those glitches could cause devastating effects.

Now being human as well, and having made my share of mistakes in interpreting images over the years, I’m not really trying to throw stones at the software folks. But when a glitch is found, there are ways to deal with it, and ways NOT to deal with it.

The latter is easy to recognize. Say one has a shiny new PACS system that skips CT slices intermittently. Telling the customer that it’s an issue with the code, and the next fix will come roughly a year after the software went online is probably NOT the best approach. Having a PACS that sometimes doesn’t inform the user that there are prior issues, and spending lots and lots of time backpedalling and outlining how the issue was bounced back and forth and back again within the corporate structure is definitely NOT how I want things handled.

So how should our friends in the medical software market do their mea culpa’s? An excellent question. Here is how Merge Healthcare did it with two recent letters to their customers.

These two notices arrived January 27, 2016:

URGENT: MEDICAL DEVICE RECALL
Recall #2016-012
January 27, 2016
Dear Radiology Manager or PACS Administrator,
This is to inform you of a product recall involving:
Product:
Merge PACS™ V6.0.2.0 MR2 and earlier. We shipped these products May 2006 through June 2010, or earlier from Amicas. 
Issue:
This recall has been initiated due to an issue in which the patient name in the Halo title bar may not update to match the name on displayed images due to the JAVA running out of memory.
Potential Harm:
Use of this product may result in a mismatch of the displayed patient name on the Halo title bar and the displayed images. 
Product Containment:
A software update has been released which adds a warning message to the user interface for the user to close some viewers whenever the Java memory usage size exceeds 97%. The use of Merge PACS does not need to be discontinued.
Instructions:
An upgrade for Merge PACS is available for this issue. Call Merge Customer Service at (REDACTED) to schedule the upgrade. 
If you decide to decline this maintenance release, please complete (REDACTED)
   
Please ensure that all users of the product are provided with this notification. Your assistance is appreciated and necessary to prevent patient harm.
If you may have further distributed this product, please identify your customers and notify them at once of this product recall. Your notification to your customers may be enhanced by including a copy of this recall notification letter.
Merge Healthcare is committed to improve efficiencies and enhancing the quality of healthcare worldwide. If you have any additional questions, call Merge Customer Service (REDACTED)
This recall is being made with knowledge of the Food and Drug Administration.

And…

URGENT: MEDICAL DEVICE RECALL
Recall #2016-012
January 27, 2016
Dear Radiology Manager or PACS Administrator,
This is to inform you of a product recall involving:
Product:
Merge PACS™ V6.0.2.0 MR2 and earlier. We shipped these products May 2006 through June 2010, or earlier from Amicas. 
Issue:
This recall has been initiated due to an issue in which the patient name in the Halo title bar may not update to match the name on displayed images due to the JAVA running out of memory.
Potential Harm:
Use of this product may result in a mismatch of the displayed patient name on the Halo title bar and the displayed images. 
Product Containment:
A software update has been released which adds a warning message to the user interface for the user to close some viewers whenever the Java memory usage size exceeds 97%. The use of Merge PACS does not need to be discontinued.
Instructions:
An upgrade for Merge PACS is available for this issue. Call Merge Customer Service at (REDACTED) to schedule the upgrade. Reference this recall #2016-012.
If you decide to decline this maintenance release, please (REDACTED)
   
Please ensure that all users of the product are provided with this notification. Your assistance is appreciated and necessary to prevent patient harm.
If you may have further distributed this product, please identify your customers and notify them at once of this product recall. Your notification to your customers may be enhanced by including a copy of this recall notification letter.
Merge Healthcare is committed to improve efficiencies and enhancing the quality of healthcare worldwide. If you have any additional questions, call Merge Customer Service at (REDACTED)
This recall is being made with knowledge of the Food and Drug Administration.

You get my drift. Face up to the glitches, let the customers who haven’t yet found them know they exist, and FIX them. Sounds like a plan. A plan other vendors need to follow a bit more religiously.

via Blogger http://ift.tt/1mkufkf February 06, 2016 at 01:23PM