Customer Spotlight: New hospital in Dublin completes Phase I of MEDITECH implementation
By: Donna Carroll, Editor
Over the past year, I've had the pleasure of performing some international recruitment, an endeavor which has taught me a lot (probably more than I ever wanted to know) about work permits, international work standards, and true cultural differences in the business world! Although there were many challenges along the way, a creative mindset and one very dedicated CIO served well to accomplish the recruitment goals of our client. With our client having recently completed Phase I of their MEDITECH implementation, I took some time to talk with the CIO about the project. Below is a summary of my interview with him.
FACILITY:
Hermitage Medical Clinic, Dublin, Ireland 
DESCRIPTION:
The Hermitage Medical Clinic is a private, acute care facility with 101 inpatient beds, 24 day beds, 8 ICU beds, and 7 Operating Rooms.
INTERVIEWEE:
Mike Gogola, CIO
BACKGROUND:
Mike Gogola has managed the implementation and operation of MEDITECH at 24 hospitals. Under his watch, two hospitals have won the “100 Most Wired Hospitals” award.
Mike is a Diplomate Member of ACHE, a Member of CHIME, a Fellow with HIMSS, and a Member of the EU MUSE Board. He is a graduate of the University of Wisconsin with a BS degree in Business Management and received his MBA from Roosevelt University in Chicago. Mike has previously served as a MUSE Western Regional Director and International Board Member.
What is the overall scope of this project?
The scope of the project is to implement MEDITECH at a start-up hospital, utilizing full-time super-users, along with IT staff and MEDITECH consultants, to fully implement the system. The key element is utilization of dedicated, full-time super-users in each of the departments.
Which MEDITECH modules are you implementing?
We’re implementing over 15 modules of MEDITECH MAGIC v5.5. We’ve taken a phased approach to include the following:
Phase I: ADM, MRI, PCI, OE, B/AR, GL, LAB
Phase II: BBK, NUR, CWS, ORM, MM, AP, SCA, PHA
Phase III: POM
At what stage are you in the project?
We have recently completed Phase I and are just beginning with Phase II. The timeline for implementation is:
Phase I: 12/06 thru 4/07
Phase II: 5/07 thru 1/08
Phase III: Around 3/08
Aside from MEDITECH, what other systems or software are you implementing?
We’re also implementing GE Centricity RIS/PACS system, and Iguana HL7 Integration Engine (from Toronto-based company, iNTERFACEWARE).
Who comprises your project team?
Our project team is comprised of 7 IT staff, 1 Radiology staff, and numerous department super-users. Specifically, we have 1 Applications Manager, 2 Clinical Analysts, 1 Financial Analyst, 1 Network Manager, 1 PC Support Technician, 1 PACS Administrator (in IT), and 1 PACS Manager (in Radiology). Our staff is a multi-national team with members coming from the United States, Canada, South Africa, and, of course, Ireland.
What is the biggest difference between Ireland’s healthcare system and the U.S. healthcare system?
Ireland has a public healthcare system. Residents are taxed by the government with a portion going toward healthcare services. As a result, there are extremely long wait times for medical care, especially in the ER. Medicare and Medicaid do not exist in Ireland. You can purchase private health insurance fairly inexpensively, and this would allow you to receive medical care at private hospitals in order to avoid long wait times in the public facilities. There are relatively few private hospitals in Ireland, with just 3 new facilities built over the last few years. But, these are the only new private facilities to open in 20 years.
Having implemented MEDITECH at over 20 hospitals in the U.S., what are some of your biggest challenges in implementing MEDITECH in Ireland?
The single largest challenge to this implementation project has been recruitment. MEDITECH Inc. sold to its first Ireland customer just a couple of years ago, so there is no local pool of experienced MEDITECH professionals to draw from yet.
What specific actions were taken to overcome these challenges?
We have addressed this challenge through a variety of means. We have advertised job vacancies on the MEDITECH-L, have tapped into our professional network to find interested candidates, have utilized a professional search firm which specializes in MEDITECH recruitment, and have supplemented our staff with some short-term consultants.
In hindsight, are there any things you might do differently if you were to do this project all over again?
Not really. A lot of research and foresight went into the planning process. We tried to identify potential problems ahead of time, so that we could approach them with possible solutions, rather than be surprised by them. To some extent, we shared information with the other 2 new facilities (also implementing MEDITECH) in Ireland.
What are some important pieces of advice you have to offer other sites embarking on the same project?
The biggest recommendation I would make to any start-up hospital is to have their senior management team in place at least 1 year prior to the expected completion of construction. I was actually the first employee hired by the hospital, and began 6 months prior to the completion of construction. Our IT Steering Committee was initially comprised of myself, a local management consulting firm, and some of the hospital’s investors. I obviously had to staff my own department in order to lay the groundwork for the IT infrastructure. But, because I was the only executive at the time, I was also very involved in the recruitment process for the other key executives and department managers. In Ireland, it’s common practice for executives to give 3 months notice, and for department managers to give 1 month notice to their current employers before vacating their positions. Therefore, it took 3 months for our CEO and other executives to start work once they were selected. The department managers then had to be in place before staff members could be hired. So the entire recruitment process was a rather protracted one, and is still ongoing.
Industry Spotlight: Despite advances, most hospitals are years away from fully computerized systems
Reprinted from: Bend Weekly News, May 25, 2007
By: Keith Darce
Hospital records aren't what they used to be at Tri-City Medical Center.
Emergency room doctors record orders for lab tests, medications and treatments on wireless tablet computers. Nurses on the in-patient floors enter vital signs into rolling laptop computers. And digital X-ray images are available on computer screens throughout the Oceanside, Calif., hospital moments after they are taken.
This kind of technology was a novelty just a few years ago, but now most hospitals across the country use some sort of electronic medical records system - a technological leap proven to reduce medical errors and one that many think is key to slowing runaway health care costs.
Several RAND Corp. researchers predicted that electronic health records could save hospitals and doctors $513 billion over the next 15 years, savings that could be passed along to insurers and patients, according to a 2005 article in the journal Health Affairs.
A trip to Tri-City suggests that the digital age has finally arrived in health care, but looks can be deceiving. Despite undeniable advances, most hospitals and doctors remain years away from full-scale electronic records and for those that do use electronic records, there is little, if any, way to share information.
It wasn't supposed to be like this.
For nearly two decades, physicians, health experts and even U.S. presidents have declared the nation within reach of the holy grail of medical information technology: a vast computerized network linking hospitals, doctors' offices, pharmacies, laboratories, clinics and insurers that would allow a patient's comprehensive medical record to accompany him around the nation's fractured health care system.
"We call the electronic health record a perpetually emerging technology," said Sam Karp, vice president of programs for the California Healthcare Foundation, a nonprofit group that has helped fund several health care technology efforts.
Creating this system has proven much more difficult and costly than anyone predicted.
Many health care providers have run into problems incorporating new software systems into current systems.
The health care and software industries have been slow to adopt technical standards that are needed to allow different computer systems to talk to each other.
Some health care providers, particularly doctors, have been reluctant to invest heavily in new technology without assurances that they will reap the financial savings created by the investment.
And the legal mandate to protect patients' privacy remains a vexing challenge for those creating systems designed to share information.
After declaring in 2003 that San Diego County was only a year away from establishing a regional data network that would tie together 19 hospitals and dozens of physician practices, Dr. Stephen Carson of the San Diego County Medical Society Foundation now admits his prediction was far too ambitious and optimistic.
"I was really naive in my thinking and understanding," he said recently.
Carson isn't the only one who badly misjudged the pace of medical records computerization.
Recently, in Dallas about 3,000 gathered for Toward the Electronic Paper Record, a health care technology conference put on annually since 1984, when Ronald Reagan was president and "Footloose" topped the music charts.
The irony of the meeting's name isn't lost on Peter Waegemann, chief executive for the conference organizer, Boston-based Medical Records Institute. "I keep saying if we would have a banking industry meeting every year (with the same name) we would be laughed out of the room," he said.
In 1991, the Institute of Medicine, a medical research group associated with the National Academy of Sciences, called for all of the nation's doctors to use computerized patient records within a decade. In 1994, President Clinton extended that deadline to 2004.
More recently, President Bush called on the industry and government to create comprehensive electronic health records for most Americans by 2014.
About 68 percent of the nation's 6,000 hospitals have implemented some type of electronic medical records system, according to a 2006 survey by the American Hospital Association. But most of those systems operate in only portions of the facilities, such as in pharmacies, radiology or laboratories.
And while many hospitals have computerized nursing records, few systems let doctors enter orders for tests, medications and treatments.
Perhaps the biggest challenge is creating links between health care providers that will allow patient data to follow patients as they move among hospitals, doctors and insurers.
With some support from the federal government, health care communities in recent years have created more than 200 so-called regional health information organizations. But with limited funding resources and tepid support from health care providers focused on their own internal technology initiatives, few regional groups have gotten off the ground.
The movement took a hit at the end of last year when the Santa Barbara County Care Data Exchange, one of the oldest in the country, shut down after spending at least $20 million over the past nine years trying to electronically link three hospital systems, county health care programs and dozens of doctors.
The project's failure was blamed on a lack of long-term funding, disagreements over how to share data and keep it secure and a user scale that was too large to manage properly - problems that health care officials say have hampered many other regional groups.
"It was kind of a big-bang approach," said Karp with the California Healthcare Foundation, whose group contributed $10 million to the project.
These fits and starts should be expected considering that the computerization of medical records really is a part of a sea change in the way medical care is delivered, said Waegemann of the Medical Records Institute.
Physicians are moving from an intuitive way of practicing medicine, in which they treat a patient based on their own knowledge and experience, to so-called evidence-based medicine guided largely by mountains of data analyzed for patterns and trends, he said.
"What we are really seeing is a very traumatic historic change ... and it may take another 10 or 20 years," Waegemann said.
Recent News: MEDITECH to Acquire Patient Care Technologies, Inc. (PtCT)
April 18, 2007 -- MEDITECH, the leading vendor of health care information systems, announced today it will be acquiring its long-time partner PtCT, a leading provider of home care, hospice, tele-health, private duty, and benchmarking software. Upon completion of the acquisition, PtCT will become an independent subsidiary of MEDITECH. Lawrence A. Polimeno, Vice Chairman of MEDITECH, will assume the additional role of President and CEO of PtCT.
"We've enjoyed a long relationship, including a partial ownership stake, with PtCT since the very beginning of their founding," said Polimeno. "Both companies write software using the same technologies, and two members of our Board of Directors are long-time members of PtCT's Board of Directors. This acquisition was spurred by the long relationship between the two companies and PtCT's development of exciting, innovative solutions for the home care industry."
More info: http://www.ptct.com/04_18_2007.html
Recent News: Forward Advantage To Enhance Identity & Access Management Offering For Meditech Customers With Fusion From Carefx™
May 29, 2007 -- Carefx Corporation today announced an agreement with Forward Advantage® to expand its identity and access management offering by providing simplified, unified and secure access to patient information. Forward Advantage is the leading provider of identity and access management solutions for hospitals using MEDITECH healthcare information systems.
Forward Advantage will resell Fusion from Carefx™ to MEDITECH customers worldwide. Fusion from Carefx is an end-to-end solution that addresses clinicians' need to access patient information quickly and intuitively. Using innovative context management and workflow technology, Fusion utilizes industry standards to aggregate patient information from multiple systems and display it simultaneously in a unified view, regardless of where the data is stored.
More info: http://www.carefx.com/articles/release_20070529.html
Worth a Read: Articles of Interest to the Healthcare IT Field
Performance Improvement Special Report: Part I. The Landscape
By: Mark Hagland
HealthCare Informatics, May, 2007
With the backdrop of an environment that's becoming more demanding and intense every day, pioneering hospitals, medical groups and health systems are making performance breakthroughs that even a few years ago were thought impossible. They are making clear advances in improving patient care quality and safety, redesigning clinical workflow, making their clinicians and staff more efficient than ever, and reaching out to connect data and information across sites, physicians, and communities. The key enabler? The electronic medical record (or electronic health record), say industry experts and leaders at pioneering healthcare organizations.
Read article
Wag the Dog: Is your IT department running the business operations or is your business operations running the IT?
By: Pedro Rivera
HealthCare Informatics, May, 2007
Today's information technology (IT) seems to change every year from one user conference to the next. Your staff attends these professional conferences and comes back energized with the latest software updates. Why does it always seem that your healthcare organization is the only one that has been doing it the same way for the last 20 years and everyone else is so far ahead of the game?
Read article
Team EMR: How to maximize productivity and potential for both the individual and the team
By: Pam Taylor
HealthCare Informatics, May, 2007
The success of EMR teams has been proven — people collectively collaborating on the build, customization, implementation and support of systems and helping to achieve the goals of their healthcare organizations. While an EMR team can be very productive and make tremendous contributions, due to varying levels of experience, knowledge, skills and other factors, individual team members may not work to their potential and may not feel professionally fulfilled. The challenge becomes how to maximize the productivity of the team and the potential of each team member.
Read article
