Thursday, 01 September 2011 00:00

Volume 6 - Issue 4 - September 2011

Editor's Notes

By: Donna Carroll
Editor - The MEDITECH Community Bulletin
VP, Professional Search & Health IT Consulting - Systems Personnel

Welcome to the latest issue of The MEDITECH Community Bulletin. It’s been a couple of months since our last issue, and it’s been a very busy Spring and Summer for our consulting team. We’ve had the pleasure of assisting several MEDITECH hospitals with a number of projects, including:

- 5.64 Upgrade
- EPS Mapping for Clinical Review
- Order Entry (OE) Dictionary Optimization
- CPOE (POM) Implementation
- HL7 Interface Development
- Pharmacy (PHA) Dictionary Optimization
- NPR Report Writing and Conversion to 6.0 Report Designer
- ARRA Priority Pack (PP11) Update

This is a very exciting time for Health IT and our highly dedicated team (to whom I'm very appreciative) is thrilled to be a part of it. Feel free to call me if your site needs assistance with the many projects required to achieve Meaningful Use with MEDITECH.

Highlights of this month’s issue include:

Sara McNeil from Boston Software Systems contributed an article for our Guest Spot column this month entitled “Hospital Health Check”.

I had the opportunity to visit with a MEDITECH site which is now close to completing their 90-day reporting period for Stage 1 Meaningful Use. To learn about their “Noble Pursuit”, please read the article in our Customer Spotlight column.

The Healthcare IT Solutions Exchange (HITSE) is ready for its 2011 Conference on October 19th. Read about their agenda, focused on Meaningful Use, and its lineup of esteemed presenters in this month’s Industry Spotlight.

Our Featured Employer column this month features a MEDITECH LSS Specialist position at Memorial Hospital of Converse County in Douglas, Wyoming.

This month’s issue is chock full of press releases from numerous organizations in the Recent News section.

This month’s Worth a Read section contains the usual assortment of articles of interest to the Health IT field, as well as a brief profile about MEDITECH President & CEO, Howard Messing.

All information and content for the October 2011 issue of The MEDITECH Community Bulletin must be received no later than Thursday, September 29th. Thank you.

September and October are my favorite months of the year, and I hope they’re good for all of you as well. Many blessings to all of you as students return to school, families settle into their new routine, and work life resumes with renewed focus and enthusiasm. “See you” next month...

Donna

Guest Spot: Hospital Health Check

Contributed by: Sara McNeil, President, Boston Software Systems

The healthcare industry is arguably the largest business segment in the world, comprised of care facilities and caregivers as well as insurers, drug companies, clinical equipment and technology providers. Consumers struggle with different insurance plans and increasing costs. Providers work to improve quality of care, while maintaining financial viability.

It is disheartening to hear about accounts of patients arriving at an emergency room with hopes of being quickly treated only to encounter the inevitable—long wait time and lots of paperwork to complete before being examined. And even then, as they are shuffled from one department to another, they continue to fill out more forms that ask for the same information. As the healthcare business becomes increasingly competitive, administrators must recognize the importance of improving the patient’s overall experience by streamlining the flow of information throughout the organization.

One of the key challenges facing hospitals is the need to provide high-quality, efficient patient care, while keeping the hospital operating smoothly. However, as patient care gets more complex, so do the paperwork and processes. Consider the variety of information that affects a patient’s record. In addition to critical care information, there are financial records, demographic records, insurance claims, inventory accountability...it seems endless. Behind all of these touch-points are innumerable workflows and processes, including repetitive, time-consuming tasks that are done manually and filled with inaccuracies. One of the ways hospitals can boost efficiency is by streamlining back-office functions and tackling manual tasks with workflow automation technology.

These development tools allow hospital IT staff to automate workflow processes by performing manual tasks significantly faster and without errors. IT staff may automate a single time-consuming manual task, a series of tasks that make up a particular workflow, or act as an electronic manager to ensure users are following a prescribed process. Using sophisticated scripting technology, these tools can connect new technologies to legacy systems, allow a hospital to introduce new applications or systems, reduce manual workflow and improve the flow of information.

An example of the benefits of automating workflow is at Mount Auburn Hospital in Cambridge, Mass. The hospital was having problems attaching accurate patient information to specimens going from clinics and physician offices to the hospital's lab. In some cases, only handwritten patient information would accompany the specimen, creating many inaccuracies including wrong insurance, wrong address or simply illegible writing. As a result, lab personnel were spending too much time registering patients, which delayed ordering lab work and ultimately caused billing delays, costly corrections and re-billing issues. Doctors and patients shouldn’t have to wait any longer than necessary to receive critical lab results.

Mount Auburn automated the process of pre-registering patients and specimens. Now, when a patient specimen is taken, the doctor’s office sends patient information to a text file in the IDX physician system. The process at the hospital runs continuously, automatically logging in to physician offices' IDX systems to check for new files with patients to be registered.

When a patient file has been added, the information is automatically picked up, the patient is registered into the hospital’s MEDITECH system and an audit of all transactions is produced. In addition, an Excel spreadsheet that details all of the actual data sent from the physician's office is generated. Both files are produced daily and are date stamped, and the actual data is backed up. At the end of the day, a copy of the exception report and the Excel spreadsheet is emailed to a distribution list for review.

As a result, Mount Auburn has saved significant lab time and prevented many costly mistakes. The hospital has also seen faster turn-around in billing and fewer corrections. Lab personnel are now able to spend more time ordering lab work instead of registering patients.

From registration to billing, patients deserve to have a smooth, seamless experience. It is important to keep healthcare workers productive and keep facilities financially healthy so they can meet patients’ needs. By maximizing the benefits of automation technology, hospitals contribute to the broader vision of improved patient care, operational efficiency and revenue enhancement.

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Sara McNeil is President of Boston Software Systems. Based in Boston, MA, Boston Software Systems is the leading standard for workflow automation and system integration software, enabling healthcare organizations to streamline complex business processes and improve productivity. For more information, visit www.bostonsoftwaresystems.com.

Customer Spotlight: Meaningful Use … A Noble Pursuit

Noble Hospital

By: Donna Carroll, Editor, The MEDITECH Community Bulletin

I recently had the opportunity to meet and visit with the Information Technology (IT) staff at Noble Hospital in Westfield, Massachusetts. I have always known about Noble Hospital as they’re located just ten minutes from my home. However, Noble Hospital had never held the reputation of being a premier MEDITECH site as they historically used a relatively small number of applications. Well, at least that was the case until now!

Noble Hospital is a 97-bed non-profit community hospital. They are the sole acute care facility in the Noble Health Systems organization. From its inception in 1893, Noble Hospital has grown and flourished due to the outpouring of support from its local community. Through the years, these contributions have allowed for many additions, updates and renovations. Today, Noble Hospital offers a modern and well-equipped facility complemented with a roster of highly competent and compassionate medical staff, nurses and medical support personnel. There are several other hospitals in the surrounding Pioneer Valley region, however, Noble Hospital strives to be the community hospital of choice for residents of the Greater Westfield area.

Our local newspaper printed a recent article about how Noble Hospital had just started to use CPOE. The article was very general in nature and never mentioned MEDITECH as the software vendor. Of course, I knew that Noble Hospital was a MEDITECH site and wondered how they got from point A to point B in such a relatively short period of time. So, I called Noble’s IT Director, Bob Borr, and within just a few days, I was on-site for a tour and interview with Bob and his Manager of Nursing Informatics, Lori Smith, RN.

So Much to Do, So Little Time

Bob Borr joined Noble Hospital as Director of IT in February 2010. Upon performing a current and future state analysis, he quickly realized that the hospital’s prior attempts to meet Meaningful Use requirements had been delayed to such an extent that he was practically starting at the ground floor.

Although Noble Hospital had been LIVE with MEDITECH since 1986, they were using a limited number of clinical applications, specifically LAB, RAD, PHA, OE, and PCI. In the Fall of 2009, they also went LIVE with NUR documentation for inpatient units.

So, in order to meet all of the Stage 1 Meaningful Use requirements, Noble Hospital would have to implement the following:

Update to version 5.64 with ARRA Priority Pack,
Electronic Medication Administration Record (eMAR),
Bedside Medication Verification (BMV),
Version 2 Allergies,
Clinical Review (EPS),
Physician Desktop (PWM),
Provider Order Management (POM/CPOE),
Ambulatory Order Management (AOM/RXM),
Physician Documentation (PDOC),
Public Health Interfaces,
CCD Interface, and
Data Repository (DR).

Furthermore, their timeline was to go LIVE with POM/CPOE by February 2011, and to complete any remaining requirements by the end of June 2011. If met, this timeline would allow the hospital to begin their 90-day reporting period beginning July 1, 2011 and to self-attest by October 2011.

First, Bob had to do some pretty fancy footwork to convince their MEDITECH representative that Noble would be ready to go LIVE with POM/CPOE by February 2011. Once he managed to get a commitment from MEDITECH to support their implementation, Bob then had to determine what resources would be needed to accomplish their goal. He had a small staff to begin with and only two Application Analysts at the time.

At the recommendation of several of his staff, Bob launched into action to re-hire a critical team member who had recently left the organization. Lori Smith, RN had been a member of Noble Hospital’s caregiving team for nearly 15 years prior to migrating to their IT Department in 2007. Enthused by the new project plans under Bob’s direction, Lori re-joined Noble Hospital in February 2010 as Manager of Nursing Informatics.

Lori recalls the week that she and fellow Analysts, Sheila Valente-Gamber and Hallie Joy, attended PCM dictionary training at MEDITECH. “We were simply amazed at the amount of work ahead of us. At the conclusion of training, the three of us made a pact that no matter how difficult the tasks, we would remember that we were teammates working together on the project and would try not to get too testy with each other, no matter how many hours were required to get the job done.”

The work load was intense as this one initiative entails numerous projects, most occurring simultaneously. Fortunately, Bob Borr’s leadership approach is to lead by example with a ‘can do’ attitude. He calmly encourages his staff, helps maintain their focus on the critical tasks, ‘runs interference’ with organizational leadership, holds the vendor accountable for delivering the service required, and ensures his staff is well-equipped with the knowledge and resources necessary to get the job done. “It truly was a tremendous amount of work, but you have to remain positive and focused, and remind everyone that you really can see the light at the end of the tunnel.”

Removing Barriers and Enabling Mobility

One of the biggest challenges Bob’s team faced was garnering physician involvement in the initiative--a fairly common story! Bob and Lori are the first to admit that it would have been ideal to have the physicians participate in the design process. Unfortunately, however, it was very difficult to bring them all together and to dedicate any providers to the project. Since they were operating under a very strict timeline, the decision was made to forge ahead with the build process, incorporating all of the knowledge from other clinical staff to design a system that best suited the physicians’ current ordering practices. In addition to the IT team which was dedicated to the project, they managed to pull in some per-diem assistance from other department employees to participate in the design and build process. This helped tremendously when it came to understanding physicians’ ordering practices on different units.

So, a plan was needed to ensure the providers would be prepared to go LIVE with POM/CPOE once it was ready. Lori Smith developed the training curriculum, along with a very detailed training manual providing step-by-step instructions, chock full of screenshots and helpful tips. Prior to go-LIVE, they ran a pilot in TEST for two weeks to allow the providers to become familiar with the system. In addition, all providers were offered four hours of one-on-one training.

In February 2011, Noble Hospital went LIVE with seven hospitalists using POM/CPOE. The hospitalist team at Noble is responsible for approximately 80% of the patient population. Since that pilot group, they have added a few more providers. To date, Noble is entering 53% of unique patient orders for inpatients. That puts them far above the 30% threshold required for Meaningful Use.

noble_sheilahallie A common objection from providers using CPOE is the lack of mobility. They often feel tethered to the computer and don’t like having to rely upon a workstation. Handheld devices are certainly convenient, but not very practical for CPOE. Enter the iPad. Lori Smith wanted to give MEDITECH a try on her own personal iPad. So, they asked Network Manager, Nick Symiakakis, to connect her iPad to the hospital’s network. While an iPad may not be the ideal device for all MEDITECH applications, it did prove to be successful for CPOE and other physician-facing applications. So, each provider has been issued their own iPad for use with MEDITECH. On the floors, each nurses’ station has at least two desktops as well as one workstation-on-wheels (a.k.a. WOW) for every nurse on day shift. This ensures that each nurse and provider have access to a device at all times.

The Road from Point A to Point B

Since my visit to Noble Hospital, they have completed implementation of RXM and Data Repository. They have also successfully completed testing of their Public Health and CCD interfaces. Noble is actually the first hospital in Massachusetts to complete both of these. So, the hospital began their 90-day reporting period at the end of May—a full month ahead of schedule. They have obtained their EHR Certification ID, and will attest to meeting all Stage I Meaningful Use requirements at the end of August. Noble Hospital hopes to see their first check some time in September or October 2011.

noble_loribob_connected The road from point A to point B has been long, yet rewarding. Under Bob Borr’s leadership, Noble Hospital has transitioned from underutilizing their MEDITECH system to being on the forefront of Meaningful Use compliance. While the anticipated incentive payments will most definitely benefit the hospital, the primary reason for them pursuing Meaningful Use was patient safety. Lori Smith noted that once all patient orders are being entered online, she will sleep better at night. “It’s a matter of knowing that patient safety is of the utmost concern to our facility.”

Meaningful Use…a very noble pursuit, indeed! And this is just one of the reasons why Noble Hospital is the community hospital of choice in the Pioneer Valley region.

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To learn more about Noble Hospital, visit them online at http://www.noblehospital.org/.

Industry Spotlight: HITSE 2011 Provides Unique Opportunity for MEDITECH Customers

HITSE Healthcare CIOs will want to take note of the second annual Healthcare IT Solutions Exchange (HITSE) scheduled for October 19 in Dedham, Massachusetts. This event provides a unique collaborative environment in which to learn how to successfully stage your approach to meeting Meaningful Use objectives.

Unlike most other meetings or conferences, HITSE is built around a one-to-one exchange of information between peers, providers of Meaningful Use solutions and four leading healthcare technology experts.

The date and location of this event are perfect for those of you attending the MEDITECH Physician/CIO Forum. HITSE takes place the day before and is being held just a short distance from MEDITECH's Canton headquarters.

The theme and focus of HITSE 2011 is "Meaningful Use: Staging for Achievement." Attendees will learn from their peers, vendors and the experts about which approaches and processes are proving to be the most effective for staging Meaningful Use and why.

HITSE 2011 features these respected presenters:

Looking "Beyond Meaningful Use" is the issue covered by John D. Halamka, MD, MS, a Professor of Medicine at Harvard Medical School, Chief Information Officer of Beth Israel Deaconess Medical Center, Chief Information Officer of Harvard Medical School, Chairman of the New England Healthcare Exchange Network (NEHEN) and more.

Anthony J. Guerra is the founder of healthsystemCIO.com, an online publication featuring the healthsystemCIO.com Survey Panel — a group of more than 130 CIOs who participate in "SnapSurveys" about the most pressing issues of the day. Guerra will speak on "How CIOs are dealing with HITECH/Meaningful Use mandates."

Vice President of Medical Affairs for McKesson's Paragon Business Unit, Michael Blackman, MD, MBA will be presenting "What's Old is New Again: Physician Adoption in the Era of Meaningful Use." A member of the product development team, Blackman can provide great insight into this important topic.

Lastly, Karen M. Bell, MD, MMS — who is Chair of the Certification Commission for Health Information Technology (CCHIT®) — will address "EACH: Overcoming Barriers to Certifying Installed EHR Technology." She brings to the Commission wide and varied expertise in health information technology (HIT), quality assurance and clinical practice.

Joining these four experts is an expansive line-up of practiced vendors representing consultants and providers of productivity tools, data storage and management, integration solutions and tools that interface directly with MEDITECH MAGIC, Client Server and 6.x.

One of the highlights of HITSE 2011 will be its CIO Forum, a panel of CIOs discussing what is and is not working in their efforts to meet Meaningful Use objectives. Moderated by Guerra, this fully interactive one-and-a-half-hour session is a must for CIOs wanting insight into how their peers are staging for achievement of Meaningful Use.

Participants will learn what steps your fellow CIOs are finding to be productive as well as what types of solutions are being evaluated and implemented. Attend and be prepared to share your questions and experiences.

It promises to be a valuable, information-packed day. Those interested in learning more about this event can visit http://hitse.org/.

Featured Employer: Sponsored by MeditechCareers.com

The online career hub for MEDITECH professionals

Every month, we feature one employer who has advertised their job posting on our affiliate web site: MeditechCareers.com. In addition to the basic job posting, we provide some information about the employer, their location and environment, and highlight them as a "Featured Employer" in this newsletter.

To advertise your MEDITECH-related opportunity on MeditechCareers.com and become a "Featured Employer", contact Donna Carroll at 413-569-1111.

MEDITECH LSS Specialist
Memorial Hospital of Converse County
Douglas, Wyoming

About the Organization:

Memorial Hospital of Converse County (MHCC) is a state-licensed, Medicare-certified, 25-bed Critical Access Hospital located near downtown Douglas, Wyoming. Converse County is home to more than 12,000 people, half of which live in the community of Douglas. In addition to the hospital in Douglas, MHCC operates rural healthcare clinics in Glenrock, WY and Guernsey, WY. More than 300 employees work at MHCC. Family Practice with Obstetrics, General Surgery, OB/GYN, Internal Medicine, Orthopaedic Surgery, Podiatry, and Radiology are the areas of focus at MHCC. Thirteen physicians are employed by the hospital with numerous support physicians contracted for Emergency Department and Anesthesia. MHCC has invested millions in infrastructure, recently implementing EMR, eEmergency, ePharmacy, and eICU. Their digital surgery suites are state-of-the-art and the finest in the state. The newly remodeled radiology department boasts SPECT-CT and the latest in Volume Imaging.

About the Location:

Nestled along the North Platte River, Douglas, Wyoming is listed among the 100 Best Small Towns in America. Douglas's 6000 residents enjoy, in-town access to fishing, canoeing and rafting. The community's location affords residents an abundance of summer and winter sports, including downhill and cross-country snow skiing, snow mobiling, water skiing, boating, camping, hiking, rock climbing, fishing and hunting. Public lands within driving distance include national forests, state and national parks, wilderness areas, big game refuges, and national recreation areas. Located just 50 miles east of Casper and 130 miles north of Cheyenne, day trips include great destinations like Denver, CO, the Rocky Mountain National Park, Mount Rushmore, Devil's Tower, and much more. The community is well-rounded with great schools, churches, and civic organizations, making Douglas the perfect place to work, play, and live.

About the Department:

Memorial Hospital of Converse County's Information Systems department is comprised of 4 staff members and the CIO. The skill sets of the individual team members cover a large segment of the informatics world including operations, financial, and clinical analysis, project management, HIT implementation, interfaces, server and desktop technologies, etc. The department is currently focused on the initial stages of an EMR project centered around Meditech and LSS 6.0.

Position Profile:

Applicants should be comfortable in the development and implementation of EMR as it relates to Meditech and LSS 6.0. All staff members in the Information Systems department report directly to the Chief Information Officer who in turn reports to the Chief Executive Officer. Job duties will include development of orders and order sets, development of physician and nursing documentation templates, creation of training materials, hands-on work in process analysis and alteration as it relates to EMR. Secondary responsibilities would include working as a direct liaison to providers in the inpatient and clinic settings, and working with other Information Systems team members to resolve issues that impact other portions of the organization.

Qualifications:

Applicant must have a firm understanding and experience with LSS (PWM, AOM, RXM, APR, MIS) and MEDITECH (PCM, MIS, PCS, RAD, PHA, LAB) as they relate to Physician Documentation and CPOE. Applicants must have understanding of these products in the 6.0 enviornment. Other IT related skills considered a plus. Ability to relate to and understand physician requests is important.

How to Apply:

Email your resume to Karl Hertz, Recruitment Manager, or review the posting on our website and apply online. To learn more about Memorial Hospital of Converse County, go to: www.conversehospital.com.

Recent News: Happenings in the MEDITECH & Health IT Community

Summit Healthcare Raises the Bar for Interface Engine Functionality, Ease-of-Use and Security with Newest Version of Summit Express Connect

BRAINTREE, MA, August 29, 2011 -- Summit Healthcare, a leader in healthcare system integration and task automation, today announced the latest version of its industry-leading interface engine, featuring a wide range of new features and enhancements that set a new standard for functionality, ease-of-use, stability and security.

Volume 6 - Issue 4 - September 2011

Editor's Notes

Guest Spot: Hospital Health Check

Customer Spotlight: Meaningful Use … A Noble Pursuit

Industry Spotlight: HITSE 2011 Provides Unique Opportunity for MEDITECH Customers

Featured Employer: Sponsored by MeditechCareers.com

MEDITECH LSS SpecialistMemorial Hospital of Converse CountyDouglas, Wyoming

About the Organization:

About the Location:

About the Department:

Position Profile:

Qualifications:

How to Apply:

Recent News: Happenings in the MEDITECH & Health IT Community

Worth a Read: Articles of Interest to the Health IT Field

Columns

Upcoming Events

MEDITECH LSS Specialist
Memorial Hospital of Converse County
Douglas, Wyoming