Volume 3 - Issue 1 - February 2008

Change of Contact Info: We've made it onto the map!

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

I'm pleased to announce that we've finally made it onto the map! Literally, that is. After more than a dozen years in the beautiful foothills of the Berkshire Mountains in a town so small it wasn't even on most maps, we have moved locations. Even though we left the small town behind, we're still in a picturesque location and I hope to share more wildlife photos with you in the future. Below is our new contact information. Please make note of the change in your address book. Thanks!

Donna Carroll, CPC
Systems Personnel
414 College Highway
Southwick, MA 01077
TEL: 413-569-1111
EMAIL is unchanged: Donna@CarrollSearch.com

Vendor Spotlight: Dependable Technology Bridges ... Davidson Partnership Saves Hospitals from Drowning in the Sea of Unreliable Infrastructure

By: Bill Wellman, Principal, The Davidson Partnership, LLC

The Challenge:

In the era of advanced clinical information systems, infrastructure is essential. Without a reliable infrastructure, the clinical systems required to provide safe, quality patient care won’t work. Nursing documentation, CPOE, EMR, EDM and other applications require a fast infrastructure or clinical professionals won’t embrace these applications. When applications aren’t available, clinicians can’t provide the best care for patients. When applications are slow, clinicians find workarounds, some of which are questionable or unsafe. The longer systems are slow or unavailable, the louder the voice of the clinical community. In the most extreme situations, the clinical community alleges the systems are unsafe and will eventually cause patient harm. The MEDITECH applications are proven and tested, but to work effectively they need an equally high quality infrastructure (devices, networks, wireless, servers, etc.). With the variety of technologies from different vendors that must be implemented to create a working system, it is easy to understand why achieving fast reliable performance is challenging.

Design is the key to a reliable infrastructure. Lack of redundancy and aging servers, desktops and network devices present an additional set of challenges. Medical Device vendors under FDA regulation often run outdated versions of operating systems and virus protection software, arguing they can’t make changes without appropriate FDA approval. This outdated software can become infected with viruses that spread to other hospital systems. These issues are often compounded by the need to deploy without creating downtime. Effective design can mitigate risk associated with these issues.

The Davidson Partnership, LLC can bridge the gap between MEDITECH and the diverse infrastructure technologies required to make it work. Through years of project experience in diverse environments we’ve acquired the knowledge needed to fit MEDITECH and infrastructure architectures together in a workable solution capable of providing the performance your clinical professionals deserve and expect.

Davidson Partnership Can Help:

One of the greatest challenges for information systems leaders is buying the right technology to do the right job in the organization. The right technology works both today and well into the future. It doesn’t become obsolete before it’s deployed in the hospital. Unfortunately, in the rapid paced healthcare IT environment, we’ve seen vendors sell technology that they subsequently sunset within months of when it arrived at the hospital. In other cases we’ve seen software and hardware delivered that has significant issues with the current version of MEDITECH the hospital is running. Hospitals have invested a lot of resources in trying to make the technology work, only to have the technology vendor eventually admit that a known bug exists and their technical staff is working on fixing it.

We can help hospitals avoid these problems. Our experience enables us to ask the right questions. We can assist hospitals in testing new technology to ensure appropriate interoperability. Our systematic approach of evaluating, selecting, testing and implementing technologies with great attention to detail, helps our clients eliminate risk and improve reliability.

Our Approach:

We utilize a systematic technology evaluation and acquisition approach to ensure organizations acquire and implement the right technology. Our approach encompasses four levels of technology assessment:

• Compatibility Analysis
• Usability Analysis
• Future State Scenario Planning
• Targeted Proof of Concept

In the compatibility analysis, we review the testing performed by the vendor in environments similar to the one that exists in your organization today. We also look for comparable sites that have implemented the product and are using it in production. We evaluate these environments to determine the extent to which the technology has been demonstrated to integrate with technologies present in your environment.

Usability focuses on the extent to which the technology functions in an acceptable manner for a variety of individuals in their daily work. If the technology doesn’t function in an acceptable manner, these individuals often utilize work-arounds that introduce inefficiencies, introduce errors, or may simply be unsafe. Our usability analysis seeks to identify aspects of the technology that are working and those that aren’t working in similar environments.

Most healthcare organizations have a technology roadmap that is guiding their future technology investments. This roadmap should be aligned with the organization’s clinical/ business strategy. Our future state scenario planning looks at the portfolio of technologies an organization will be using in the future and seeks to assess the extent to which the technologies under consideration will be compatible with the future technologies.

After our analysis is complete, we develop a picture of the high risk areas. Based upon this risk analysis, we design a proof of concept that focuses on high risk areas in an effort to eliminate these risks. Vendor contracts can then be negotiated contingent upon successful completion of the proof of concept.

Our methodology reduces the risk that technologies will not operate together harmoniously in the hospitals production environment.

Technology Bridges:

As organizations work to integrate applications and information technologies, they often identify “gaps” between the different vendor products and MEDITECH. Sometimes the technology doesn’t work as advertised. These “gaps” often require organizations to create elaborate work-arounds that allow the technologies to interoperate. For example, the MEDITECH Materials Management (MM) module isn’t easy for a mobile Materials Management professional to work with. The mobile professionals need a mobile device that allows them to quickly inventory exchange carts. As we looked at this problem, we created a technology bridge, MediStock, that runs on any hand-held or desktop device that runs a web browser. The application operates over the hospitals existing wireless network, allowing information to be collected on the device and automatically transmitted to a server where the information is then uploaded to the MEDITECH MM module.

As hospitals migrate to new applications, important data is sometimes left stranded in the old application as there is no place to store it within the new application, or the data definitions are completely different (incompatible meta-data). We often find this situation when helping hospitals with their conversions. A related situation arises when hospitals wish to retire an outdated system that is only being used to store data that is no longer being updated. Maintenance costs continue to increase for what has become a legacy data storage warehouse. As we looked at this gap, we created a technology bridge, MediView, that functions as a low-cost storage and retrieval system for the legacy data. MediView can also be used in conversions to house data that can’t be migrated to the new application. Organizations often find the reduction in maintenance costs for the legacy system can yield a savings in as little as 12–18 months.

One of Davidson Partnership’s core competencies is the design and construction of innovative bridges that enable hospitals to improve their performance and enhance patient safety.

Ensuring Success:

Let The Davidson Partnership assist you in reducing risk, improving infrastructure reliability, and enhancing the success of your implementation. For further information, please contact us at sales@davidsonpartnership.com or call Jen Fortin, VP of Sales, at 603-890-8530.

Open Invitation:

If you have an infrastructure challenge we would welcome hearing from you. If you would like to join one of our MediStock or MediView webinars, please contact us at sales@davidsonpartnership.com. We have regularly scheduled sessions and would welcome your participation.

Bill Wellman is a Principal with The Davidson Partnership LLC, with over 25 years of experience in health care information systems management, consulting and education. Prior to joining Davidson Partnership he was a Vice President with First Consulting Group, and has functioned as the Information Systems Executive for several healthcare organizations. Bill currently holds an adjunct faculty appointment at Harvard University, and has also been as a faculty member for Rush University and for JCAHO. Bill has served on numerous boards including being a founding board member of Status One, a leading high-risk patient management firm. He is a Past President of the Boston Chapter of the Society for Information Management. Bill holds a Bachelors degree in Social Science from Michigan State University and a Masters in Industrial and Operations Engineering from the University of Michigan.

Tricks of the Trade: Auditing MAGIC Scheduled Reports

Contributed by: John Sharpe, President, Comstock Software, Inc.

A recent audit request prompted me to write an NPR Report to identify current extracts for a BAR Third Party Administrator (TPA). While a standard MEDITECH report did exist off the MIS Spooling menu; it was not targeted towards the information I needed. Let’s retrace my steps by writing such a report in the MIS.JOB data procedure module (DPM) in the ‘mis.job.day.list’ Detail Segment. Since I know that my users will appreciate this report being sorted by Spool Group; I’m going to jump ahead and add the MIS.JOB.schedule.spool.group as the report’s index.

I find business users in Patient Financials prefer such information communicated in a spreadsheet format; so let’s structure this report as a Meditech DOWNLOAD. To keep this article on topic, I’ve included MEDITECH Download Tips at the bottom of this article.

On page 2 of the report writer; we set the MIS.JOB.active field to “Y”; because our users have requested current extracts going to a particular vendor. We also set up the keyword CO as a SELECT on MIS.JOB.report.name to select all schedule entries with a report in the desired (in this case BAR) DPM.

On page 3, we set the fields: spool.group, database, job.mnemonic, user, day, report name. Other fields in this DPM that may be useful to your users: frequency, report.title, spool.comment, start.date and status.

Because this is a DOWNLOAD; we set a FOOTNOTE of FD (field delimiter) of 44 as the ASCII code for a comma.

To run the report for all BAR scheduled reports, enter the free text "BAR" in the lookup.

I’ve taken the liberty of importing this file into Microsoft Excel, which you could pivot or filter to the user’s needs.

MEDITECH Download Tips:
- http://comstock-software.com/blogs/npr/2006/01/meditech-npr-download-tips.html
- http://comstock-software.com/blogs/npr/2007/10/multiples-in-downloads-npr-report.html

John Sharpe is President / NPR Consultant at Comstock Software, Inc. John hosts the ‘Meditech NPR Report Writing’ blog at http://comstock-software.com/blogs/npr/ where you can learn and read more about NPR Report Writing.

Featured Employer: Sponsored by MeditechCareers.com

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 will provide some general information about the employer and their environment, and highlight them as a "Featured Employer" in this newsletter.This new web site was created in order to give MEDITECH professionals a place to explore career options and opportunities. Visitors to the site will be able to view MEDITECH-related job postings and submit their resume for consideration. Having a separate web site for this purpose will allow us to maintain the original focus of The MEDITECH Community Bulletin on our loyal readers who are seeking news and information rather than job postings. We certainly hope this new web site will provide some value to the MEDITECH user community.

Alice Peck Day Memorial Hospital
Lebanon, New Hampshire

About the Organization:
Alice Peck Day Memorial Hospital (APD) is located in the picturesque upper Connecticut River Valley, adjacent to the town of Hanover, NH, which was voted one of the “Best Towns in America” to live in and earned the title of Sports Illustrated's “Sportstown for New Hampshire”. APD is a small hospital with big opportunities throughout the facility. APD is known for providing the best in personal care in a family and community attitude with friendly and helpful employees. If you possess a caring spirit, are dedicated to making a real difference in the well-being of every patient, have a great work ethic and desire an opportunity for development and professional advancement a position awaits you here.

History: In 1932, Alice Peck Day Memorial Hospital opened its doors with a staff of three; one superintendent, one day nurse, and one night nurse. The nine-bed hospital admitted an average of three patients per day. Lebanon's first "cottage hospital" was the gift of Alice Peck Day, born September 7, 1860, at her family's residence, The Peck Homestead, site of the original hospital. When Alice passed away in 1927, she bequeathed her "homestead and the entire estate to establish a cottage hospital...". The APD system of health care is supported by over 450 employees, physicians, and allied health professionals, in over 30 specialties and clinical areas, all working together to provide a comprehensive health care experience. We take pride in giving our patients the personal care and attention they deserve.

About the Location:
Located in the Upper Connecticut River Valley at the intersections of the states of New Hampshire and Vermont, Alice Peck Day Medical Center is close to recreational activities such as alpine and x-country skiing, hiking, biking, boating, excellent public and private school systems, Dartmouth College, Dartmouth Hitchcock Medical Center, Norris Cotton Cancer Center as well as many cultural venues for music, theatre and other arts. The Upper Valley (as it is called) is only 1.5 hours from Manchester, NH and Burlington, VT airports, and only 2 hours from Boston. The small town atmosphere, in the beautifull hilly country-side is a highly desirable location for both families and young professionals to live. The state of New Hampshire also has neither a sales tax, nor a state income tax.

About the Department:
The Information Services department is a small and personable team of professionals who work very closely together to provide services to the hospital and APD-owned clinics. Services include Telecommunications, Networks (LAN & WAN), Desktop systems, and Applications Support for the primary systems of Meditech MAGIC 5.5, and Amicas PACS, interfaces/integration, as well as several smaller applications for other organizational functions (billing, dictation, time and attendance, etc.). Current or near future projects include an ambulatory EMR for the clinics, a campus-wide Wireless Network and Outlook Exchange.

Current Position(s) Available:

Information Systems Analyst - Financial/Billing
Permanent, Full-Time

Description:
The Financial/Billing IS Analyst works with existing analysts, programmer analysts, and management on the Information Systems Team. This individual will be responsible for supporting and enhancing the financial and billing applications within the MEDITECH MAGIC HIS system as well as other ancillary financial applications being implemented ( Eligibility Verification, 3rd Party Statement Vendors, MCR D Billing, EMR). This individual will participate in the implementation of automated financial processes (electronic claims processing, enhanced claim checking, electronic remittances/denial management, contractual arrangement management), and will work closely with user departments to define data and reporting needs. This position has a strong emphasis on programming skills for providing IT solutions to business problems and to meet ongoing business needs.

Minimum Qualifications:

• BS or Associate degree in Information Technology or other related field

• 3-5 years of experience in Information Technology in the above mentioned role

• Healthcare Accounting experience highly preferred

Experience Required / Desired:

• MEDITECH MAGIC experience

• ESP Billing Software experience

• MEDITECH NPR report writing

• Microsoft Office Tools

• Interface People Script/Assist

• Front-end reporting tools like MS Access and/or Crystal Reports

• Project Management

• Experience in programming and database analysis/design with SQL, MS Access, Visual Basic, and/or MUMPS

How to Apply:
To apply for this Job, please email your resume to Lorraine Nichols and reference job "Financial/Billing IS Analyst".

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Clinical Information Systems Analyst - EMR Project
Permanent, Full-Time

Description:
The Clinical IS Analyst works with existing analysts, programmer analysts, and management on the Information Systems Team. This individual will be immediately responsible for implementing a new Electronic Medical Record (EMR) in the APD-owned clinics, including interfaces to the MEDITECH HIS system. It is expected that this individual will attend 3-4 weeks of training by the vendor which will certify this individual to lead the implementation. This individual will work with the project team members, including physicians and other clinicians, in documenting and redesigning workflows to maximize efficiencies. Once implemented, this individual will be the primary support for the EMR application, including future enhancements. It is also expected that this person will learn and support various modules in the MEDITECH HIS system as assigned, and share overall support with the other analysts for the MEDITECH system. This position has a strong emphasis on programming skills for providing IT solutions to business problems and to meet ongoing business needs.

Minimum Qualifications / Requirement:

• BS or Associate degree in Information Technology, Nursing Informatics or other related field

• 5 - 8 years of experience in Information Technology and/or Clinical Informatics

• Ambulatory clinic or Practice Management experience

• License in Nursing, Practice Management, or related field

• Implementation and/or support of a clinic EMR application

• Excellent communication skills, written and verbal

• Team building

• Project Management

• Healthcare Accounting experience highly preferred

• Experience in programming and database analysis/design with SQL, MS Access, Visual Basic, and/or MUMPS

• Microsoft Office Tools

• Front-end reporting tools like MS Access and/or Crystal Reports

Experience Required / Desired:

• Interface People Script/Assist

• MEDITECH NPR report writing

• MEDITECH MAGIC clinical applications

How to Apply:
To apply for this Job, please email your resume to Lorraine Nichols and reference job "Clinical IS Analyst".

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Clinical Information Systems Programmer Analyst
Permanent, Full-Time

Description:
The Clinical IS Programmer Analyst works with existing analysts and management on the Information Systems Team. This individual will be primarily responsible for developing and maintaining interfaces between the MEDITECH HIS system and other applications (PACS, EMR, Transcription, etc.); participating in the implementation and support of automated clinical applications; working with user departments to define data and reporting needs; and directing quality assurance efforts through the creation of test plans and test matrixes.

Minimum Qualifications / Requirement:

• BS or Associate degree in Information Technology or other related field

• 3-8 years of experience in Information Technology in the above mentioned functions

• Healthcare industry experience

Experience Required / Desired:

• MEDITECH NPR report writing

• SQL syntax and queries

• Microsoft Office Tools

• Scripting tools

• HTML

• Database analysis and design (relational)

• Interface technologies and languages

• Front-end reporting tools like MS Access and/or Crystal Reports

How to Apply:
To apply for this Job, please email your resume to Lorraine Nichols and reference job "Clinical IS Programmer Analyst".

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Recent News: MEDITECH's Advanced Clinical Systems MAGIC 5.6 Receives CCHIT Certification

January 22, 2008 -- The Certification Commission for Healthcare Information Technology (CCHIT) announced on January 22nd that MEDITECH's Advanced Clinical Systems MAGIC 5.6 meets the Commission's inpatient electronic health record (EHR) criteria for 2007. CCHIT is an independent, nonprofit organization and is the Recognized Certification Body in the United States for certifying health information technology products.

More info: http://www.meditech.com/aboutmeditech/pages/newsmeditechcchitcert.htm

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Recent News: DrFirst and MEDITECH to Deliver Sophisticated Medication Reconciliation and Electronic Prescribing to Hospitals

January 4, 2008 -- DrFirst, the leader in electronic prescribing and medication reconciliation, and Medical Information Technology, Inc. (MEDITECH), the leader in the health care information systems industry, have announced a strategic alliance to integrate DrFirst’s medication history and e-prescribing technologies with MEDITECH’s hospital-focused Client/Server and MAGIC applications. The agreement will provide hospitals with comprehensive patient medication history information as well as electronic prescribing of discharge and outpatient medications.

More info: https://radium.drfirst.com/press/pr_meditech.htm

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

2008 Innovative Awards Winners Driven to Succeed
HealthCare Informatics, January, 2008

Read on for a refreshing professional and personal look at (and possibly some inspiration from) the nine winners of the 2008 HealthCare Informatics Innovative Awards.
Read article

Pulling Back the Curtains
By: Mark Hagland
HealthCare Informatics, December, 2007

Early pioneers of quality and pricing transparency in Pennsylvania, Omaha and Wisconsin talk about their efforts to deliver the goods to the healthcare purchasers and payers.
Read article

Next Generation EDIS
By: Daphne Lawrence
HealthCare Informatics, December, 2007

Connectivity can be the deciding issue in this discussion of “best of breed” versus an enterprise EDIS.
Read article