Volume 4 - Issue 5 - July 2009

Editor's Note

By: Donna Carroll
Editor - The MEDITECH Community Bulletin
VP, Business Development & Recruitment - Systems Personnel

Welcome to the latest issue of The MEDITECH Community Bulletin. Below are just a few of the items found in this month's newsletter:

• The 2009 International MUSE Conference took place in Vancouver, British Columbia on May 26th-29th. Pat Korolog-Mulberger, RN, and Suzanne Catalforno, RPh, delivered a very informative presentation entitled "Surviving the Data Jungle". For those who were unable to attend the conference, Pat and Suzanne have been kind enough to share their presentation with us in this month's Guest Spot column.

• Our Industry Spotlight column discusses the synoptic reporting requirements now imposed upon all accredited cancer programs. Learn how one software company, mTuitive, is leading the way to enable MEDITECH hospitals to meet these important industry requirements.

• John Sharpe of Comstock Software is once again sharing his wealth of NPR knowledge in our Tricks of the Trade column. We thank John for his knowledge and tips each month!

• NEW!  Due to popular request, we now offer Banner Advertising on our site.  The MEDITECH community is a very specific market, so why advertise on sites where only a small percentage of their audience are MEDITECH users?  With our affordable prices and very targeted audience, you're sure to be seen by MEDITECH users across the country (and even abroad)!  Learn more about our banner advertising rates and details.

• All information and content for the August issue of The MEDITECH Community Bulletin must be received no later than Tuesday, July 28th. Thank you.

Happy Summer!
Donna

Guest Spot: Surviving the Data Jungle--A Team Approach for Beginners Using MEDITECH's Data Repository

By: Pat Korolog-Mulburger, RN & Suzanne Catalforno, RPh, Kalispell Regional Medical Center

EDITOR'S NOTE:

Anyone who attends a MUSE Conference knows just how much valuable information is available through the various workshops, peer group sessions, and presentations offered by different organizations and individuals. The following is a synopsis of one such presentation delivered by Pat Korolog-Mulberger and Suzanne Catalforno at the 2009 International MUSE Conference which was held in Vancouver, British Columbia, on May 26th to 29th.

SYNOPSIS OF PRESENTATION:

This presentation addresses healthcare challenges brought about by needs for immediate data extracts to make good business decisions in healthcare. At Kalispell Regional Medical Center, our IT staff had difficulty keeping up with NPR report requests. We also recognized that our end-users may have an idea of what they wanted on an NPR report initially, but seeing that data would trigger needs for more data. In the summer of 2008, we began a search for a different reporting tool and after selecting Dimensional Insight's DIVER software, we developed a different approach to accomplish our reporting needs. We now utilize staff from all disciplines to build report models that can be used to aggregate data as well as to drill down into the data to find the meaningful details. Those familiar with their areas using MEDITECH and Medhost EDIS software are working together with IT to build robust models that achieve their reporting needs. The presentation reviews our approach to have various departments come onto the model-building team to build a committed ownership into the process as well as to expedite data extraction. We are now working on adding KRONOS HR and Timekeeper as well as Midas, Comp Data and eClinicalWorks to the models we have already built.

>>>Click here to download the PowerPoint Presentation<<<

BIOGRAPHIES OF THE PRESENTERS:

Pat Korolog-Mulberger, RN, BSN - Applications Specialist

Pat worked as a staff nurse and an Assistant Head Nurse for 20 years prior to leading the Meditech HCIS build in a rural facility in 1995. She became a Meditech consultant in 1998 and led multiple Client Server implementations. Pat came to Kalispell Regional Medical Center as an Applications Specialist in 2001 and is now the Clinical Informatics Nurse. She has published several articles on clinical implementations and has presented six times at the International MUSE convention. She is an intermediate NPR Report Writer and is also versed in Crystal Report Writing. Buried with requests for NPR reports Pat searched for a new solution. She found DIVER at a MUSE convention, pitched it to her facility and was the lead in the DIVER project implementation.

Suzanne Catalfomo, RPh - Pharmacy Informatics Specialist

Suzanne presents her experience of the transition from building NPR reports to building some dynamic models in the DIVER application. Suzanne has been the Pharmacy Informatics Specialist at Kalispell Regional Medical Center for the past 4 years and is on the DIVER core team.

Industry Spotlight: An mTuitive Approach to Synoptic Reporting for MEDITECH Hospitals

The Commission on Cancer (CoC) is the accreditation arm of the American College of Surgeons. "The CoC is a consortium of professional organizations dedicated to improving survival and quality of life for cancer patients through standard-setting, prevention, research, education, and the monitoring of comprehensive quality care." For cancer programs, this designation is as important as accreditation from The Joint Commission (JCAHO).

For several years, the CoC has required that surgical pathology reports for cancer patients follow protocols and checklists developed by the College of American Pathologists (CAP). Cancer centers were encouraged to submit reports in the synoptic or checklist format provided by the CAP, but until now, there was no requirement to do so.

Beginning in 2009, Accredited Cancer Programs are no longer encouraged, but required, to report using the synoptic format. The goal is to standardize cancer reporting at the time of diagnosis to improve outcomes analysis for cancer treatment and research.

The difference between synoptic and structured data reporting is a source of constant confusion. The difference may appear to be a question of semantics, but is more importantly one of the usefulness of information. Synoptic simply means to provide a summary or “synopsis” of the pertinent findings. A structured report captures data that can be readily stored in a database for analysis or use in other functions, such as decision support. The alternative to a structured report is narrative, free text that will require abstraction for use in a database. A synoptic report does not have to be structured, it can be free text, but it loses it value as structured data.

Most clinical reports including pathology are narrative text with no structure. The text can be copied into a file which can be parsed or mined for data elements, but in an unstructured format it loses the power of a searchable database. Structured data by definition is information ready for entry into a database. Structured data has far more value than text in providing relevant, searchable information. Structured databases allow the task of data abstraction to be relegated to search queries rather than the manual task of report dissection and inspection in text driven systems. In text systems, a certain percentage of the data is completely missed by text parsers. Structured data reporting carries the distinct advantage that 100 percent of data is captured and reported. Time and resources are saved and data integrity and patient safety are increased. Structured data reporting facilitates coordination of care and reduces the chance for medical/clerical errors.

Structured data also provides the ability to create data driven rules or make derivations for decision support. For example, in pathology, structured data can be used to automatically grade or stage tumors. In turn this data can be re-used to derive treatment alternatives. Eventually structured data is necessary to measure outcomes. Which therapies or treatments work best on specific cancer diagnoses.

mTuitive, a Massachusetts software company, has developed a synoptic/structured reporting system to be used by pathologists for compliance with the CoC requirement. Interestingly, the application was designed by Dr. William O’Toole, who was MEDITECH’s first customer back in 1969. Dr. O’Toole was the chief of pathology at Cape Cod Hospital for many years until founding mTuitive five years ago.

The application, xPert for Pathology, works with all pathology and laboratory systems, but most of its users are MEDITECH customers. This is due in part to an innovative program sponsored by Cancer Care Ontario (CCO), a provincial agency responsible for continually improving cancer services. With one of its many initiatives to automate the reporting of cancer pathology data across Ontario, CCO encourages synoptic reporting among its provincial hospitals. MEDITECH is the preeminent HIS vendor for Ontario hospitals, but those hospitals have had little success using MEDITECH questionnaires to build synoptic forms which meet the CCO data standard. mTuitive’s xPert for Pathology application provides customers access to all 71 CAP Cancer Checklists.

xPert for Pathology can be used with any hospital or lab information system (LIS), and even as a stand alone application (without an LIS) to perform synoptic reporting. mTuitive is one of only four vendors certified by CCO to comply with its standards. To date, 13 Ontario hospitals have successfully implemented mTuitive’s synoptic reporting solution. There are also 3 hospitals that have implemented Sunquest CoPath Plus whose synoptic reporting capability is provided by mTuitive.

The software is easy to install, works with both MAGIC and Client Server architectures, and can be readily interfaced. In addition to delivering CoC compliance, many customers report that the software actually pays for itself by reducing transcription cost and accelerating pathology report delivery. Customers have measured an average reduction in turn-around-time of two days.

Dr. Paul Cook, director of pathology at the Phelps County Regional Medical Center, was mTuitive’s first MEDITECH customer. Phelps installed the software in preparation for their initial certification inspection required to be designated an accredited cancer treatment center. After the inspection, Dr. Cook stated "the mTuitive program is simple to use and adds comprehensive value to our reports. The AJCC inspector was most impressed with our path reports. With the help of this software we are now an accredited cancer program."

To learn more about mTuitive, call them at (508) 771-5800 or visit them online at www.mtuitive.com/.

Tricks of the Trade: Use Diff Merge to Compare / Validate MEDITECH Reports

By: John Sharpe, President, Comstock Software, Inc.

Manually comparing 2 reports is hard on the eyes and tedious work. Like most IT workers, you know there must be an easier way. And, you’re right - there is another way. Source Gear has developed a free software application Diff Merge. Diff Merge allows you to visually compare 2 files.

Next time you’ve finished a change to a MEDITECH report; DOWNLOAD 2 copies of the report to your desktop computer. One copy will be from the Production report, the second copy will be from the Development report, where you’ve made your changes. Then use Diff Merge to compare and review file differences. You’ll find this method of comparing files to be more accurate than manually spot-checking your changes. Once you’ve validated your changes, you’ll be able to pass the baton to your MEDITECH end-user for Acceptance Testing.

To get started, you might need approval from your IT Leadership to install this free utility. Then download and install Diff Merge from http://www.sourcegear.com/diffmerge/.

1. Print your Production report to DOWNLOAD. Select Download and Browse. Save report output using a meaningful file name.

2. Print your Development report to DOWNLOAD. Select Download and Browse. Save report output using a meaningful file name.

3. Navigate to your computer’s desktop; right click and compare the 2 files. You will need Diff Merge already installed on your computer to perform this step.

4. Click OK to continue.

5. Review the files in Diff Merge. Lines that have differences will be highlighted.

6. Make changes as appropriate to your Development report until you are ready to turn the report over to end-users for Acceptance Testing.

Using Diff Merge to quickly get an estimate of what’s changed, between the Production and Development version of a report, means you’ll have fewer surprises when your report goes LIVE.

Thoughts or Questions? Email them to John at jsharpe@comstock-software.com.

John Sharpe is President / NPR Consultant at Comstock Software, Inc. Learn more about NPR Report Writing at the MEDITECH NPR Report Writing Blog.

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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.

Systems Personnel
"Your Partner in Healthcare Search"

About the Organization:

Founded in 1989, Systems Personnel is a professional search firm specializing in the nationwide search and placement ofInformation Technology, Management, and Sales & Marketing professionals in the Healthcare industry. We pride ourselves on our personal approach to your job search. We become your partner in the search process and will guide and advise you each step of the way. We take the time to discuss each candidate’s background, experience, career goals, and personal interests prior to presenting them to a client a for a specific opportunity.

Systems Personnel is a “Preferred Member”of Top Echelon Network, Inc., the nation's largest network of independent professional search firms. Our massive networking capabilities allow us to conduct a very targeted search and provide you with the best available opportunities.

Services:

Systems Personnel performs a variety of placement and staffing services on a nationwide basis. All fees are paid by client companies, and there is never a fee to candidates.

• Permanent Placement
• Interim Management
• Contract Staffing
• Temp-to-Perm Hiring

Specialties:

MEDITECH Health Care Information Systems:

Systems Personnel has provided search assistance to the MEDITECH community since 2000. Over the years, we have established quite a large network of clients, candidates, and affiliates. Below are the types of positions and professionals with whom we work.

• Application Support / Systems Analysis
• Implementation Consulting
• NPR Report Writing
• Programming (NPR, MAGIC, HL7 Interfaces, etc.)
• Project Management
• System Assessments & Training

Information Technology:

Systems Personnel has maintained a niche focus in a few key software markets. Since technology is ever-changing, we try to remain flexible and will always try to fulfill your specific search requirements. Below are some of the areas in which we have specialized.

• Nursing Informatics / Clinical Informatics
• Hospital Information Systems (HIS)
• Electronic Medical / Health Records (EMR/EHR)
• Physician Practice Management (PPM)
• Computerized Physician Order Entry (CPOE)
• Pharmacy Information Systems
• Medication Administration Record (MAR) & Medication Reconciliation
• Radiology Information Systems (RIS)
• Picture Archiving and Communication Systems (PACS)
• Laboratory Information Systems (LIS)
• Patient Accounting, Financial, Administrative applications
• Emergency Department Information Systems (EDIS)
• Software Implementation & Maintenance
• Application Integration & Interfaces
• System Assessments & Training

Healthcare Management:

Systems Personnel specializes in the search and placement of both department-level and executive management professionals in the Healthcare industry. Below are some of the Department Leaders (Directors, VP’s and CXO's) with whom we work.

• Allied Health Services
• Facilities Management & Operations
• Health Information Management / Medical Records
• HIPAA Privacy / Security
• Hospital Administration
• Human Resources
• Information Technology & Services
• Nursing / Patient Care Services
• Patient Finance / Revenue Cycle Management
• Practice Administration
• Quality / Risk Management Rehabilitation Services

Sales & Marketing:

Systems Personnel works with a variety of software vendors and service providers to the Healthcare industry. Our clients include well-established companies as well as growing start-ups. We help build or re-vamp Sales & Marketing organizations by identifying seasoned professionals with a demonstrated record of success in our clients' target market. Below are some of the areas in which we concentrate.

• Health Care Information Systems (HCIS)
• Clinical Applications Software
• Revenue Cycle Solutions
• Consulting / Outsourcing Solutions
• Sales & Sales Management

Position Profile:

Our client, a multi-facility health care system located in Massachusetts, is currently seeking MEDITECH POM Consultants to assist with the rollout of CPOE to their multiple facilities. They need additional resources as team members to assist their in-house staff with this implementation. Qualified candidates must have prior experience implementing MEDITECH CPOE/POM, specifically in dictionary building and testing. Additional experience in clinical worflow analysis, and end-user training and support is desired.

How to Apply:

To learn more about Systems Personnel, visit us online at www.carrollsearch.com. EOE. Interested and qualified applicants may email your resume or call Donna Carroll at:

Systems Personnel
Donna@CarrollSearch.com
TEL: 413-569-1111

Recent News: Saint Anne's Hospital is going digital

FALL RIVER, MA, July 8, 2009 -- In an attempt to improve the quality of care provided to its patients, Saint Anne's Hospital launched a new electronic documentation of medical records Tuesday. The hospital aims to eliminate time-consuming paperwork and risk of mistakes that come with it.

The fourth hospital in the Caritas Christi Hospital System to implement Advanced Clinical Systems, St. Anne’s has rolled out half of a two-pronged electronic conversion. Tuesday’s launch included patient care systems that allow clinicians to document assessments, problems and plans for care, and Bedside Medication Verification, where a barcoding scanner is used to match a patient to their medication at the point of care, eliminating legibility issues that come with hand-written prescriptions and dosages.

Carole Billington, vice president of patient care services for St. Anne’s, said the system integration cost the hospital $2.5 million. That cost covered the purchase of a computer system that included carts, laptops. desktops and counter mounts and barcode scanners, and paid for training more than 500 staff members. Registered nurses were trained a total of 16 hours.

Read article...

Recent News: Florida hospital goes wireless with new tower

DAYTONA BEACH, FL, June 15, 2009 -- Halifax Health's new 500,000-square-foot, high-tech medical facility in Daytona Beach, Fla., is poised to open this week equipped with a wireless network aimed at boosting mobility and productivity for clinicians and staff.

The network from Sunnyvale, Calif.-based Meru Networks is based on the latest 802.11n wireless standard. It spans all 10 floors of the new North Tower, including 180 private rooms and an 89,000-square-foot emergency department containing the area's only trauma center.

The network will provide connectivity for mobile workstations that support applications such as electronic medical records, bedside bar-code scanning for drug-dosage verification, and remote video interpreting for hard-of-hearing patients.

Read article...

Recent News: Hyland Software acquires Valco Data Systems

CLEVELAND, OH, July 1, 2009 -- Hyland Software today announced that it has purchased privately held Valco Data Systems, a provider of document management, document imaging, workflow and health information management (HIM) integration solutions focused on the healthcare market. Terms of the transaction were not disclosed.

"Healthcare is the single largest segment of our business, and also one of the fastest growing," said A.J. Hyland, president and CEO of Hyland Software. "Our acquisition of Valco strengthens our portfolio of solutions for healthcare providers, especially those that rely on systems from MEDITECH.".

Founded in 1994, Valco is a full-service company providing software, integration, consulting, support and training services to over 300 hospitals, regional health information organizations (RHIO) and integrated delivery networks (IDN) across North America. The company is best known for providing paperless hospital solutions designed to work together and integrate with software from MEDITECH, a leading vendor in the healthcare informatics industry.

Read article...

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

Meet Your New Best Friend
By: Mark Hagland
HealthCare Informatics, July, 2009

CIOs are realizing that successful clinical IT implementations are almost impossible without strong CMIOs.

Read article...

Get Out - And Stay Out
By: Daphne Lawrence
HealthCare Informatics, July, 2009

With readmission penalties on the horizon, CIOs are laying the groundwork for post-discharge solutions.

Read article...

Eco-nomics
By: Kate Huvane Gamble
HealthCare Informatics, July, 2009

Despite a tough economy, many CIOs are incorporating eco-friendly initiatives into their strategies.

Read article...