Economic Stimulus Funds Will Benefit Small E-Records Companies

This article by Jacob Goldstein (www.wsj.com) discusses the potential windfall profits as E Records become a necessity in medical facilities, both large and small:

"Big companies including General Electric Co. will likely profit from the billions of federal stimulus dollars going to doctors who buy and use electronic health records. But little-known niche players could be among the biggest winners.
One such company is eClinicalWorks, a closely held firm in Westborough, Mass. The company, founded a decade ago by computer-programmer Girish Kumar Navani, his cousin and his physician brother-in-law, now has about 750 employees and expects $100 million in revenue this year. In the next few years, the company plans to hire 500 more people, up from 150 before the stimulus bill was approved.
"As of Dec. 31, we had put together a game plan saying, 'This economy looks like it's really getting bad. Why don't we be a little bit prudent?'" Mr. Navani says. "It changed in four weeks to, 'You will hire for growth; forget hiring for need.'"
The $787 billion stimulus package Congress approved in February promises more than $20 billion in outlays for health-information technology, coming mostly between 2011 and 2015, according to an estimate from the Congressional Budget Office. Physicians using electronic records will be eligible for more than $40,000 each in Medicare incentive payments over several years starting in 2011. Hospitals can also qualify for millions of dollars in incentive payments. Doctors and hospitals not going electronic by 2015 will be subject to penalties.
"We never anticipated the kind of dollars we're talking about today -- never in our wildest dreams," says Steven Plochocki, chief executive of Quality Systems Inc., a publicly traded company that sells electronic records under the brand NextGen.
An electronic health record, sometimes called an electronic medical record, replaces a patient's paper file. EHR systems can incorporate safety features such as automatically alerting a doctor if a patient has prescriptions for drugs with dangerous interactions. Proponents believe EHRs can also reduce wasteful spending from unnecessary testing, help doctors spot trends in their practices and enable agencies such as Medicare to pool anonymous medical data to track public-health issues.
Skeptics say that sharing information electronically will require the creation of complex data networks. Worries about patient privacy also persist. And many physicians say the systems can be expensive and difficult to use. The cost often runs to tens of thousands of dollars per doctor in the first year -- and several thousand dollars a year after that.
A federally funded survey published last year found that only 13% of practicing doctors used a basic EHR system, and only 4% used what the authors called a "fully functional" system.
Key details of how the money will be distributed remain undecided. To receive incentive payments, doctors must demonstrate "meaningful use" of a "certified" EHR, but the legislation leaves those terms to be defined by federal officials.
GE has been in the health-equipment business for decades, but it didn't start selling EHR systems to doctors until 2002, when it bought a system from another vendor. The business is already growing at a rate of 15% to 20% a year, says Jim Corrigan of GE Healthcare IT.
But the labor-intensive aspects of adopting and maintaining electronic systems in doctors' offices can give smaller technology companies an opening to compete against big corporations, says Eric Brown, an analyst at Forrester Research Inc.Shares of publicly traded specialists such as Quality Systems, Allscripts-Misys Healthcare Solutions Inc. and Cerner Corp., have outperformed the broader market this year. Earlier this month, eClinicalWorks gained a national distribution channel when Wal-Mart Stores Inc. said it will begin selling eClinicalWorks EHR packages to medical offices through its Sam's Club stores.
The installation of Dell Inc. computers and training by eClinicalWorks staff will cost a physician $25,000 for the first year, with the option of adding additional doctors in the practice for $10,000 each. After the first year, the price will fall to about $5,000 a doctor annually.
Mr. Plochocki of Quality Systems says consolidation among vendors is likely, and he says that his company is considering a few acquisitions this year. Quality Systems has also been beefing up its sales force, he says.
Allscripts is using its business selling billing software to doctors as a jumping off point, selling EHR systems to its existing customers. Glen Tullman, the company's CEO, says a physician customer recently explained why he would rather buy both billing software and an EHR system from a single vendor: "If something goes wrong, I want one throat to choke," the doctor said."

Boston Doctors donate money to save layoffs at Beth Israel Deaconess Medical Center

Another interesting post by Sarah Rubenstein in today's Wall Street Journal Healthcare Blog. Check it out:

"Doctors at Beth Israel Deaconess Medical Center in Boston are reaching into their own pockets to try to help shore up the hospital’s finances.
The Boston Globe reports that the heads of 13 medical departments say they’ll donate a combined $350,000 to the hospital — about $27,000 from each one’s annual pay — to further cut down on expected staff layoffs.
Hospital CEO Paul Levy, who has been engaging in a very public dialogue about the hospital’s budget woes, said earlier this week that he expects about 150 layoffs. He had anticipated about 600 before finding alternative cost-cutting ideas.
The department heads also sent out a note soliciting contributions from about 1,100 doctors, the Globe reports. Some of those doctors are on staff, while others are affiliated with the hospital but not employed by it.
“In my two departments, I’m quite confident that the great majority of physicians will participate. I don’t know at what level,” DeWayne Pursley, chair of the Department of Neonatology and acting chair of obstetrics and gynecology, told the Globe. “People have their own personal issues. Personally, I have three kids in college.”
Levy, for his part, posted emails from hospital staffers expressing appreciation for the doctors’ help. "

Obama Stimulus Package Includes New Human Resources Requirements

From BLR Business and Legal Reports, February 17, 2009:

"On Tuesday, February 17, President Barack Obama signed an economic stimulus package that includes a COBRA subsidy for laid-off workers and other HR-related provisions.
Both chambers of Congress approved the American Recovery and Reinvestment Act late last week. The final version of the legislation includes a COBRA subsidy for laid-off workers. The subsidy will be 65 percent of the COBRA premium for a period of 9 months--employers (or health plans if they administer COBRA benefits) will receive a credit against payroll taxes to offset the subsidy. The premium subsidy will cover workers who were affected by involuntary terminations occurring between September 1, 2008, and January 1, 2010.
There is an income threshold as an additional condition on an individual's entitlement to the premium subsidy during any taxable year. Taxpayers with gross income that exceeds $145,000 will have to repay the entire amount of the premium subsidy. For taxpayers with gross income between $125,000 and $145,000, the amount of the premium subsidy that must be repaid is reduced proportionately.
The legislation requires that information on the COBRA subsidy be included in COBRA notices. Under the legislation, the Department of Labor will create a model notice within 30 days of enactment.
The legislation also includes other HR-related provisions. For example, it increases weekly unemployment benefits by $25. The legislation also provides an extension of the temporary emergency unemployment compensation program (which provides up to 33 weeks of extended benefits) through December 2009. Under the program, no benefits will be payable for any week beginning after May 31, 2010. The legislation also provides unemployment compensation to workers who leave an employer for "compelling family reasons," such as domestic violence, illness or disability of an immediate family member, and the need to accompany a spouse to a place from where it is impractical to commute and due to a change in location of the spouse's employment. The Department of Labor will define immediate family member."

The Relationship Between Staffing Firms and Staffing Buyers in Today's Economy

This post comes from a blog by Jon Osborne. It confirms why staffing buyers and staffing firms establish long term business relationships.

"At last, staffing buyers have staffing firms at their mercy. The economy is in shambles. Staffing firms are cutting internal staff and offices. Many such firms, mom & pop outfits especially, will go under in 2009. Competition for the now shrinking pie of staffing business is fierce. This is the best opportunity in years for staffing buyers to finally stick it to their staffing suppliers.
That thought is no doubt occurring to at least a few people. We all want to save money, especially in these times. Anyway, all's fair in love, war and staffing—right?
It would be fair, even practical and desirable, if this were a marketplace of innumerable ever-changing entities, like the stock market or commodities exchange. But staffing is about ongoing relationships—a long series of repeated transactions between people—and in a relationship you want to last, you need to preserve your partner.
A sizeable portion of the staffing community will be challenged for survival this year. Buyers may want to think, not just about doing business with their preferred suppliers, but about keeping those suppliers in business—not just out of soft and fuzzy feelings but because preferred suppliers are preferred, and also because the more suppliers there are, the more competitive and responsive the marketplace.
Buyers say they want staffing suppliers to be true business partners—not just vendors. This is the year—the greatest opportunity in a long time—to reach out and establish that partnership, not just with continued business deals, but by letting your suppliers know what is or isn't coming down the pipeline, so they can adjust internal resources as needed.
Take a genuine interest in the survival of your staffing suppliers in this troubled time, and you will win real personal loyalty, and establish a true partnership—an intangible asset that will pay tangible dividends."

Best and Worst Excuses for Not Going to Work

An amusing survey for a Friday courtesy of "HR Strange But True" and Careerbuilder.com .....enjoy!

"Employees have a variety of excuses to explain an absence from work to their employer. Some are typical (e.g., "I am sick") and some are atypical (e.g., "My psychic told me to stay home"). We have 11 more of the latter for you. Tell us if you think these are really good excuses or really bad ones.

CareerBuilder.com conducts an annual survey among employers and employees on absenteeism. This year, when the survey asked employers to identify the strangest reasons employees have given to explain an absence, they cited the following examples:
Employee's wife burned all his clothes, and he had nothing to wear to work.
Employee didn't want to lose the parking space in front of his house.
Employee hit a turkey while riding a bike.
Employee said he had a heart attack early that morning, but that he was "all better now."
Employee donated too much blood.
Employee's dog was stressed out after a family reunion.
Employee was kicked by a deer.
Employee contracted mono after kissing a mailroom intern at the company holiday party and suggested the company post some sort of notice to warn others who may have kissed him.
Employee swallowed too much mouthwash.
Employee's toe was injured when a soda can fell out of the refrigerator.
Employee was up all night because the police were investigating the death of someone discovered behind her house.

If one of your employees called you with one of those excuses, would you believe him or her?
The survey found that 33 percent of employees admit to calling work with a fake excuse to explain an absence at least once this year.
The top reasons for doing so included:
Needed to relax and recharge (30 percent)
Had to go to a doctor's appointment (27 percent)
Catch up on sleep (22 percent)
Run personal errands (14 percent)
Catch up on housework (11 percent)
Spend time with family and friends (11 percent)
Wanted to miss a meeting, buy some time to work on a project that was already due, or avoid the wrath of a boss or colleague (9 percent)
Are employees fooling their employers? Not all the time. The survey found that 31 percent of employers said they have checked up on an employee who called in sick.
The most common ways those employers checked up on employees included:
Requiring the employee to show a doctor's note (71 percent)
Calling the employee at home (56 percent)
Having another worker call the employee (18 percent)
Driving by the employee's house or apartment (17 percent)
The survey included more than 6,800 workers and 3,300 employers.

A Virtual Tour of Our New Offices!

Why I Love Working at All Medical Personnel

What I do:To a certain extent, I am a professional matchmaker. I am President of All Medical Personnel, a staffing firm that I launched in 1991. My job is to introduce qualified job candidates to employers who need those individuals to work for them.
To ensure that both sides are mutually satisfied with the match, I spend a great deal of time sifting through all the criteria—personal and professional—that could impact the employer-employee relationship. It’s not about shouting “Voila!” because I’ve spotted a job positing that appears to coincide with a resume I’ve received. To achieve the ultimate fit, I do plenty of research as well as establish genuine relationships with candidates and clients.
If the coffee pot in the office runs low, I also make an excellent brew!
What got me interested in this:As an attorney with an MBA, I have worked for the major corporation and the prominent law firm. However, I believe I inherited the independent spirit of my parents, who both owned businesses and now come to work for me at times. All Medical Personnel, which is all about introducing people for their mutual benefit, seemed a great fit for my personality and my skills. My satisfaction comes from offering services that improve the lives of others.
Best part of my job:I enjoy the people, most especially my employees, clients and job candidates. Years of networking with other business owners in my industry has also enabled me to exchange ideas and establish friendships with many terrific people.
Atlanta’s business community has grown dramatically yet continues to retain elements of Southern hospitality. We have endless opportunities to get involved and well-acquainted. I love that!
Most challenging part: Nothing stays the same, which is the reason why I’m in business! I have to keep up with the ever changing needs of my clients; the amended laws and regulations that impact such factors as procedures for testing and screening applicants; the newer and better technology, the shifting demographics; the list goes on and on!
Our capacity to be flexible and evolve, expanding and tweaking our services as the issue becomes pertinent to our clients, is a vital reason for our success.
What people don’t know about my job:Doing this job well requires a tremendous amount of energy and enthusiasm. You just can’t fake it. Yes, the people we serve absolutely know that we are dedicated, but I wonder if they realize how much fun my team and I have at the office.
We work long hours, yet we all look forward to coming in every day. We are a lighthearted bunch with a huge appreciation for humor. People tell us that we make them smile, but if they could only see us behind the scenes! We work and laugh hard. What keeps me going:I have a true passion for what I do. It’s gratifying to learn from a client that our personnel lessened her workload so that she is at last leaving the office in time to have dinner with her family. Or by taking a candidate under wing we have presented career opportunities that will impact his life forever.
Preparation needed for this job:Because I own and operate the company, my responsibilities entail a working knowledge of a number of operational areas—sales, marketing, personnel, accounting, purchasing. A strong business background is important.
Being an attorney has also enabled me to expand my in-house services to clients as well as take care of my own business, but a law degree is not a requirement in this industry. You can always hire trusted professionals to handle functions that may not be your forte.
However, one valuable qualification that we cannot gain overnight is life experience. We also cannot buy compassion or commitment.
For instance, sometimes my role is to coach an applicant so that the individual believes in his or her value. Confidence is extremely important in an interview. Therefore, I use a good bit of psychology in this business.
Other times my role is to fill a critical position so that a medical facility, for example, runs more effectively. Technically, you could say that my screening process might one day make the difference between life and death. Working with such critical parameters requires a highly methodical approach with the ability to focus on the details. Leaving no stone unturned is critical even when a candidate is part of the medical field. No matter what the job entails, our employers are counting on us to produce qualified, trusted personnel. If you’re not organized and thorough, professional staffing is not the right arena for you.
More important than anything, you should enter this business because you absolutely love helping people. If you happen to have a great sense of humor, all the better!