Echoing a theme that I’ve been pushing over at my FierceHealthcare newsletter the last two days, here’s a nasty story about the awful subject of disaster recovery.  Not only will Charity Hospital and University Hospital in New Orleans never reopen in their same place, but they have lost all their computer records.

The health care system is dealing with another major ordeal — its computers. The hospitals IT system was in New Orleans and they lost it. For some reason, their backup system also failed. Now, they have Internet access only on five laptops in their "war room." The university’s entire health care system is being run through those laptops.

For anybody in health care (or in any other business for that matter reading this) this is an almighty bloody wake-up call. How are your computer systems being backed up and where is your data. It needs to be backed up locally and also needs to be backed up redundantly somewhere much further away. Here’s an example of one service that’s literally keeping its customers’ businesses alive.

I don’t know who Charity’s CIO was, but not having their computer data backed up (if that is the case) is inexcusable. But worse is having all your medical records merely on paper in one place.  But that is of course the case for 90% of medical records in this country and probably the same proportion in New Orleans.

There are two choices here. First get a local electronic system that has redundant local and remote data back up.  Most serious IT companies have multiple centers for this eventuality.  Second, use an ASP system that handles the applications and the data in a remote place., There may be times when that’s not the best solution, but in times of complete disaster at least that data is safe.

And now put on your to-do list at the top 2 things.

One, if you are in business, go look at the state of your data back-up right now. If the place burned to the ground tonight, can you access your data immediately? Where is it? Are your suppliers set up to retrieve it?

Second, are your personal information and valuables safe?  Last week I ordered a fire-proof safe because, although I have data backed up pretty well (but not well enough as I don’t have it outside of the Bay Area but I will be changing that!) my passport, house papers, etc, etc are all in a file drawer. If you need more advice about personal data back ups, take a look at this New York Times Circuits article.

Meanwhile, if you are a vendor thinking about a way to get your ASP service in front of people, put data backup security at the top of your marketing list! Allscripts and Medem are ahead of you there, even if Glen Tullman is fudging a bit when he gets ePrescribing into the mix!

MrHISTalk had a little rant yesterday about the crappy demands from the Wisconsin Health Information Network that its users only use Internet Explorer.

User tip: those interoperability and open standards folks at the Wisconsin Health Information Exchange might want to get real web developers instead of the three doctors who appeared to have created their website (and who also run some for-profit ventures under the company name Asatte.) View it in a buggy, obsolete, and proprietary browser like Internet Explorer and it works. Try it with an open, standards-based browser like Firefox and you get this rude message: "Sorry, this page requires full support of modern browser functionality. Your browser does not support that functionality. Click here to get a current browser." Why would doctors waste time screwing around building websites when millions of Indians can do a far more professional job (and following international web standards) for $5 an hour? Even Asatte’s own site is hopelessly lip-locked onto Bill Gate’s buttocks, proudly proclaiming "Using XML to Office technology, Asatte allows authors and editors to use tools with which they are familiar, like Microsoft Word, to edit, maintain, and coordinate the creation of anything from small to massive publishing projects." Real programmers don’t "code" in Microsoft desktop applications (but doctors often do.)

But while we’re on FEMA’s case, its perhaps a little more serious that same thing is true for those people trying to use a non-IE browser while applying for disaster aid. I do though like the headline from the Good Morning Silicon Valley blog which reads, We’re a disaster agency; of course we use IE

On the other hand, I’ve sadly gone back to using IE since inexplicably a recent Firefox upgrade made it crawl on my machine.  And, now that I sometime use my GF’s Apple, am I alone in thinking that the usability of both Windows and Apple sucks, and that installing Linux didn’t seem to make things much better.

Isn’t it about time for some real innovation on (or maybe) off the desktop?

You know, you try to help get this health care system IT stuff sorted out, you try to get people on one page on this eHealth BS, you get a little Federal money to try to get some of these projects off the ground…..and they want all this damn paperwork and are getting nasty about it.

The rest of you lining up to get your noses in the NHIN trough have been warned. Apparently our Federal government views paperwork as important and sloppy accounting as a bad thing. Unless of course it leads to a disaster so major that it decides to head up an independent investigation itself….

cAt the most excellent HISTalk blog, there’s an interview with Scott Shreeve, Medsphere Co-Founder and Chief Medical Officer. Now MrHISTalk has once again got one up on THCB as when I was due to interview Scott (or was it his brother Steve?) at TEPR, he didn’t show up — at least not in the 5 minutes window I gave him before I wondered onto the next booth! But what’s clear is that the enthusiasm of his account of how Medspehere is creating a cheap hospital EMR based on VistA has at least somewhat won over MrHISTalk, a man known for his somewhat cynical account of the likelihood of open source actually getting anywhere in health care. You should absolutely read that interview, which incidentally as much as anything really shows that MrHISTalk knows his stuff and does his homework.

On the other hand I’ve also been corresponding with another true believer, Fred Trotter, who is responsible for the FreeB open source billing system. The Medsphere guys seem to be sidestepping the question of whether they are going to put their version of the VistA code back into the open source domain. And Fred seems suspicious that they will not. I hope to have Fred (and hopefully others involved in this discussion too) writing for THCB shortly, but in the meantime go check out Fred’s credo and think about whether the radical open source philosophy he espouses is a good fit for health care, and/or whether Medsphere’s reworking of VistA is the answer for smaller hospitals, and who gets all this stuff to the small practices who really need it.

Finally, you may have noticed that I didn’t answer the question I posed in this post’s title. But for those of you who are concerned as to why this stuff matters read Joe Kraus’ (Excite founder and former dangerous 4×4 driver at the Stanford Ski lodge) article on the relative costs of working with Linux and proprietary formats. Just think about the real impact of a ten-fold reduction in IT costs in the next ten years.

Presumably so it can spin off its consumer and doctor web sites more easily, WebMD is changing its name to Emdeon. Say it out loud and then wonder why they didn’t go the whole hog and call it NeonmDeon…

May be this guy got there first

Neil Versel has done a little poking around and found that when the NY Times says that CMS will give VistA away for free, they actually mean for a license fee of $2,700. So free just got quite a lot more expensive…

This title alone had me really chortling — Accenture Slams CRM As Ineffective. Beyond the fact that no one in health care has yet made CRM work, didn’t anyone at Accenture get the slight irony of this, given they made so much money in the late 1990s.

Let me spell it out a bit more clearly. Who is the leader in CRM software (you know, the stuff that’s ineffective?) Why that was Siebel System which basically invented the concept in the mid 1990s. And what did Siebel do with 10% of its pre-IPO stock? Why they gave it to Accenture (then called Andersen Consulting). And why would they do that? Was there any chance that Accenture might just tell all its clients to put in a CRM system and, given the very tight relationship between Accenture and Siebel, might that just have been a Siebel CRM that they put in?

Now they’re telling us that they didn’t work. Not to worry–remember that Andersen got 10% of the company prior to the 1996 IPO. Remember what happened next?

This article suggests that by 2001 Andersen was down to owning only 3%, suggesting that it had sold some 7% of the company over that time. Siebel’s market cap at about $8 a share is now around $4.5bn, but for most of 2000 and 2001 it was worth more than $50bn which means that if they got their timing right Accenture could have walked off with up to $3 or 4 billion in profits on their investment. All in all not bad for something their clients say is ineffective!  But they’ll need some more consulting to fix that.

The ultimate joke is that Siebel now has a new CEO. Who?  Well it’s George Shaheen, the guy who left Accenture to go to dotcom flame out Webvan at the top of the market….what goes around comes around. But don’t worry — according to the 1996 S-1, Shaheen got 88,000 shares of Siebel stock too, which split 4 times in the next 4 years giving him  over 250K shares.  So if he got any of that off at a decent number, he did just fine.

Get your conspiracy theories going. One day after the VA and CMS release VistA for small physician offices, Microsoft tells the world that its "new" OS Longhorn (or Windows 2003 or whatever it was originally) will, in a stunning piece of Redmond originality, be called Vista.

Well they could have called it LyNux. Has anyone noticed that VistA is open source and free?