February 2006 Issues

Cardiac Surgery Update -- Quick Pulse

Summary: The unofficial theme of the Society of Thoracic Surgeons (STS) annual meeting in Chicago from January 30 - February 1, 2006, was how to save the profession from inroads being made by interventional cardiologists. ♦ Coronary artery bypass graft (CABG) volume is down, off-pump procedures are flat instead of increasing, there is a shortage of applicants for cardiac surgery residencies, and the job market for cardiac surgeons is poor. ♦ And these are trends that are expected to continue.

Hospice Update

Summary: Competition has increased overall. Not-forprofit hospices are trying to target more noncancer patients, and for-profit hospices want to enroll more cancer patients. The key cost cutting area for 2006 is pharmacy ♦ Hospices are increasingly using a pharmacy to help manage pharmacy costs, with inappropriate use of brand name drugs the key target, especially Johnson & Johnson’s Duragesic A nursing shortage is affecting the entire industry ♦ Educating some referral sources -- especially oncologists, cardiologists, and pulmonologists -- is proving difficult, and experts plan to redouble their efforts♦ Palliative care is a growing trend, but it isn’t clear whether that will be a positive or a negative for hospice♦ It could feed in more patients or cause them to enter hospice much later ♦ The outlook is for more consolidation in the hospice field, more professionalism, and more use of nurse practitioners ♦ Changes in reimbursement are also expected, but no one knows what they will be.

Healthcare IT

Summary: CPOE purchase and/or installation is a major focus for most CIOs ♦ CIOs expect pay-for-performance to be a positive for IT departments ♦ RHIOs are proliferating, but there are concerns about public governance and their connectivity to each other ♦ Vendors continue to cooperate on interoperability standards to let their products work together ♦ Consolidation is expected to continue in the industry, with three or four large players likely to dominate the market in the future ♦ Most of the HCIT vendors were described as aggressive in pricing, but there is no price war ♦ Cerner introduced its own medication cabinets ♦ Eclipsys is going after Meditech customers with an overlay upgrade product ♦ Epic is viewed as the Cadillac of HCIT but expensive ♦ GE and IDX may be a powerful combination, but the proof will be in the integration♦ McKesson continues to be on most CIO short-lists ♦ Siemens will have a great product in Sorian, but it probably won’t be ready for prime time until early next year

Eyecare Update -- Quick Pulse

Summary: To check on trends in the eyecare field, 50 optometrists from 11 states were interviewed at the Broward County Optometric Association’s Gold Coast Educational Retreat in Ft. Lauderdale on January 28 and 29, 2006. They offered opinions and outlooks on silicone hydrogel contact lenses, contact lens solutions, dry eye, refractive surgery, and multifocal IOLs for cataract and refractive patients.