Sunday, 01 January 2012 00:00

Volume 7 - Issue 1 - January 2012

Editor's Notes

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

Happy New Year, and welcome to the latest issue of The MEDITECH Community Bulletin!

It’s hard to believe that it’s 2012 already. The year 2011 saw an enormous amount of project activity as so many MEDITECH sites are pursuing Stage 1 Meaningful Use. I’m always pleased to hear updates from these sites on their progress, and am happy to publish your success stories here in our newsletter.

I also want to extend my deepest gratitude to the highly dedicated consulting team with whom I work, assisting many sites with their journey to Meaningful Use. Feel free to call me if your site needs assistance with any of these projects.

Highlights of this month’s issue include:

I had the opportunity to visit with a MEDITECH site which completed it’s attestation period and met the requirements for Stage 1 Meaningful Use. To learn about how “Holyoke Medical Center Measures Up!”, please read the article in our Customer Spotlight column.

In this month’s Tricks of the Trade column, John Sharpe of Comstock Software writes about an “Unpredictable Result when MEDITECH BAR Index Used by Default”.

Our Featured Employer column this month features a Sr. Systems Analyst – Advanced Clinicals position at Noyes Memorial Hospital in Dansville, New York.

The Recent News section is chock full of press releases from numerous organizations.

This month’s Worth a Read section contains the usual assortment of articles of interest to the Health IT field.

All information and content for the February 2012 issue of The MEDITECH Community Bulletin must be received no later than Friday, January 27th. Thank you.

Systems Personnel wishes you a very happy and joyous New Year, and we look forward to working with you in 2012!

Donna

Customer Spotlight: Holyoke Medical Center Measures Up!

By: Donna Carroll, Editor, The MEDITECH Community Bulletin

Several weeks ago, I had the opportunity to meet and visit with some of the kind IT folks at Holyoke Medical Center in Holyoke, Massachusetts. Holyoke Medical Center (HMC) is a 220-bed acute care facility with approximately 1,200 employees, and a medical staff of more than 250 physicians. HMC serves a population of 180,000 in cities and towns around the western Massachusetts area. Annually, HMC discharges an average of 7,000 patients, and has an Emergency Department volume of approximately 45,000 visits. A full service facility, HMC offers a complete line of medical/surgical services, including Emergency, Critical Care, and an ultra modern Birthing Center. HMC is a member of Valley Health Systems in Holyoke.

A MEDITECH customer for over 20 years, HMC has long been considered a leader when it comes to MEDITECH, such as being the first site to use MEDITECH’s Point-of-Care eMAR software on pocket PCs back in 2007. They moved swiftly to implement MEDITECH’s Advanced Clinical applications, and have been LIVE with CPOE on their inpatient units since 2009. They later rolled out CPOE in their Emergency Department in March 2011. With HMC’s reputation of being a leading MEDITECH facility, it’s no surprise they’re one of the first MEDITECH hospitals to pursue Meaningful Use.

Meanwhile, in a hospital not so far away...

Meanwhile, approximately 130 miles away in eastern New York, another MEDITECH site was undertaking the same pursuit of Meaningful Use. Nathan Littauer Hospital & Nursing Home, in Gloversville, New York, is a 208-bed health care organization comprised of a 124-bed acute care hospital and an 84-bed residential nursing home. Although a good deal smaller than HMC, Nathan Littauer Hospital (NLH) is also a progressive MEDITECH site with the full complement of MEDITECH applications including Advanced Clinicals.

Tasked with implementing NLH’s Clinical Quality Measures, Moshgan Jones, Senior Clinical Applications Analyst, was researching the process when she saw a posting on the MEDITECH-L listserv. Andy Price, Programmer Analyst at Holyoke Medical Center, was sharing some information about how HMC addressed the requirements at their facility. From reading Andy’s postings, Moshgan sensed that Andy and HMC might be able to lend her facility some guidance. So, Moshgan initiated a conversation with Andy, which soon turned into a request to Carl Cameron, Director of Information Systems & Biomedical, for a site visit to Holyoke Medical Center.

Off to see the wizard

Soon enough, Moshgan Jones, along with NLH co-workers Georgeanna Dubois, RN (Clinical Application Coordinator), Jennifer Shwajlyk (Clinical Programmer Analyst, RN), and Tafhaim Quick (HIM Analyst), set out down the proverbial yellow brick road to see the wizard.

Sue Sullivan, RN, Manager of Application Services at Holyoke Medical Center, demonstrated how HMC designed their MEDITECH system to capture the various pieces of data required for reporting purposes. The design of their physician documentation process was ultimately a compromise between how much information providers were required to answer and how much information could be captured elsewhere from other MEDITECH applications. All potential answers to queries were built as group responses which are associated to SNOMED-CT codes. This forces the standardization of responses and collection of discrete data. For some queries, the list of potential answers is long, but it can be sorted to display as desired when used within the Physician Documentation (PCM) module.

Andy Price was responsible for implementing the SQL queries HMC uses to extract the data from MEDITECH’s Data Repository (DR). Although MEDITECH Inc. did create and provide the necessary SQL queries to customers, they are far from “plug and play”. Andy described to the group some general customizations required of the queries and then worked one-on-one with NLH’s Clinical Programmer Analyst to provide more technical details. In addition, Andy demonstrated how HMC uses Medisolv’s Indigo Dashboard for their business intelligence tool. The product provides easy-to-follow graphical displays of data so that management can quickly determine how they are measuring up against the various Meaningful Use requirements.

One absolutely critical piece to implementing the SQL queries to report on Clinical Quality Measures is validation of the data to ensure the queries factor in the appropriate patients and clinical data. This requires a group effort by a clinical applications specialist, an NPR report writer, and a SQL programmer. HMC actually spent approximately 2 months validating data retrieved via the SQL queries, prior to beginning their 90-day reporting period.

Carl Cameron, Director of Information Systems & Biomedical, also joined the group to discuss HMC’s approach and some of his concerns related to the requirements for Meaningful Use. Carl noted that one of the most important steps for any facility implementing major changes was to step back from the canvas to examine how such changes impact the users operationally in order to ensure proper workflow decisions are made from the beginning. Carl described the process that HMC conducted at the onset of their CPOE implementation. They held a 3-day off-site workflow event which removed the Physician Champions (one per specialty) from the hospital and focused them on analyzing their workflows. This approach was instrumental in minimizing the need to go back and re-design the system later. Another outcome of the workflow event was the decision made by the participating physicians that use of CPOE must be mandated across the organization. That’s a very meaningful decision!

Measuring up, above and beyond!

Under the leadership of Carl Cameron, the clinical guidance of Sue Sullivan, RN, and the dedicated members of their IT staff, HMC has systematically addressed each of the requirements for Meaningful Use. On September 16th, Holyoke Medical Center self-attested and has been approved as meeting all of the requirements for Stage One Meaningful Use. On October 1st, Nathan Littauer Hospital & Nursing Home began their 90-day reporting period for Clinical Quality Measures due, in part, to the assistance provided them by HMC.

The time and knowledge HMC shared with NLH is testimony that Holyoke Medical Center not only measures up, but goes “above and beyond”, by all standards known to the MEDITECH hospital community!

Photo Gallery (hover over photo for enlarged view):

tn_carl_sue_andy tn_andy tn_moshgan_sue tn_andy_jennifer tn_tafhaim_georgeanna

###

EDITOR'S NOTE: I’d like to personally thank Holyoke Medical Center for their hospitality, and Nathan Littauer Hospital for allowing me to accompany them on this site visit.

To learn more about Holyoke Medical Center, visit them online at http://www.holyokehealth.com/.

To learn more about Nathan Littauer & Nursing Home, visit them online at http://www.nlh.org.

Tricks of the Trade: Unpredictable Result when MEDITECH BAR Index Used by Default

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

Meditech NPR uses the BAR.PAT.account.x index by default for your BAR PAT reports, even when you have not specified an index in your report. The BAR.PAT.account.x index is subscripted by account. Since the BAR.PAT.top segment is subscripted by account as well, I’m assuming this index provides better performance than accessing the BAR.PAT.top segment directly.

bar-pat-accounts-0

Here in the object code, you can see BAR.PAT.account.x in the main DO LOOP as ?(B)BZBZX[bz].

bar-pat-accounts-1

There is one scenario where you might not want NPR to use this index: and that is where BAR.PAT.account.x doesn’t contain all your BAR.PAT.top accounts. In that case I’ve found it necessary to write a workaround to access all records in the BAR.PAT.top segment. For your future reference: the physical address for BAR.PAT.top can be found in the screen shot above or on the MEDITECH Data Definitions Page. The physical address is: $(B1)BZ[bz].

One way to get all accounts, including those not in the BAR.PAT.account.x index, is to implement ECB & ECE line attributes to print the detail from the report picture. To do that, go to the General tab of the report, and remove the Detail DPM & Detail Segment. Then use ECB & ECE attributes to loop through the data and print the detail lines on the report picture.

bar-pat-accounts-2

bar-pat-accounts-3

When you look at the resulting object code; it looks surprisingly similar. Except that now, all accounts are accessible from the BAR.PAT.top segment.

bar-pat-accounts-4

The astute reader will notice: selection criteria have not been implemented in these examples. These examples are intended for use in your TEST databases. When writing production reports, take care to limit the number of records using selection criteria or your report may run a very long time.

***

As you have questions about your ARRA and 5.6 reports, email John at jsharpe@comstock-software.com.

john-sharpe

John Sharpe is President & MEDITECH Solutions Developer at Comstock Software, Inc. Learn more about NPR Report Writing at the MEDITECH NPR Report Writing Blog.

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.

Sr. Systems Analyst - Advanced Clinicals
Noyes Memorial Hospital
Dansville, New York

About the Organization:

Nicholas H. Noyes Memorial Hospital has provided health care services to residents in Livingston, Allegany, Steuben and surrounding counties for over 100 years. During this time, Noyes has evolved from a small, rural hospital to the diverse and comprehensive system it is today. The system includes Noyes Hospital in Dansville, Livingston Health Services in Geneseo, Noyes Center for Kidney Disease and Dialysis Center in Geneseo, the Foundation for Noyes Memorial Health System and Noyes Lab Draw Station in Lakeville. All of the organizations fall under the parent of Livingston Health Care System.

Noyes, its affiliated organizations and medical staff remain committed to providing excellence in health care. To that end we have developed a vision, mission and core values that drive our staff and physicians in delivering top quality care in an environment that is clean and safe, and staffed by the most caring, compassionate and knowledgeable health care workers in the industry. Every employee at each Noyes facility understands that our patients deserve to be treated with dignity, respect and caring. At Noyes, our strength is caring, our focus is you.

About the Location:

Livingston County, New York, where Dansville is located, is within a one-hour drive south of Rochester, north of Corning, and east of Niagara Falls. The County is nestled in the heart of the beautiful Genesee River Valley in the Finger Lakes Region. Rich in heritage, Livingston County has been home to many prominent persons, among them two presidents - Millard Fillmore and Chester Arthur, Revolutionary War patriot Daniel Shays, and pioneer Nathaniel Rochester. Clara Barton organized the First Chapter of the American Red Cross in 1881 in Dansville, and native son Francis Bellamy authored the Pledge of Allegiance in 1892.

Livingston County is home to one of the nation's top ranked institutions of higher learning - the State University of New York College at Geneseo - which consistently ranks at the top of most respected college directories. The Livingston Campus Center of Genesee Community College, with locations in Lakeville and Dansville, offers opportunities for distance learning and business training.

With a population of 65,000 (2010 Census), this County prides itself on a strong industrial/manufacturing base coupled with a long-standing tradition of agricultural heritage. The quality of life is unparalleled. Although rural in character, the County's northern communities are within a local call and 15-30 minutes of cultural, recreational and medical facilities in Rochester. And, with a cost-of-living lower than the national index, Dansville is an ideal place to buy a home, raise a family, and build community with friends and acquaintances.

Position Profile:

Reporting to the Director, IT Projects, the Sr. Systems Analyst will independently oversee the MEDITECH Advanced Clinical applications with a focus on POM/CPOE. Plan implement, educate and provide ongoing support to clinicians using the hospital's Physician Care Manager (PCM) suite of applications. Assess, plan, implement and evaluate information system ongoing support needs for patient care operations. Identify and implement information system solutions that support more efficient and effective work performance managing customer expectations and aligning their strategic initiatives with Information Systems.

Qualifications:

Registered Nurse with a Bachelor's degree in a technology related field or equivalent in informatics experience in a systems analyst role.

Minimum 3 years of MEDITECH experience implementing clinical documentation, PCM, RXM, AOM, EDM, Order Set Optimization (Zynx), e-MAR and BMV strongly desired. Similar Applications Analyst experience with another vendor will also be considered.

Significant clinical experience as a bedside RN in a hospital with experience in clinical systems design and analysis, clinical operations workflow design and implementation, project and change management principles, systems QA testing and clinical systems training.

Must possess a strong understanding of healthcare strategy, operations, technology, regulatory requirements and a good understanding of the technology and processes IT infrastructure and technology.

Knowledge of physician/clinician and nursing practices in complex healthcare systems across the continuum of care required.

Strong project management skills.

Must have a working knowledge of Windows Vista, Windows XP, MS Office, MS Exchange, MEDITECH, and systems networking.

Requires excellent customer relationship management skills.

Excellent organization, planning and project management capabilities.

Ability to be self-directed and work independently.

Demonstrated ability to lead and influence others to achieve desired results.

How to Apply:

To learn more about Noyes Memorial Hospital, visit us online at www.noyes-hospital.org.

Email your resume, or apply online today.

Recent News: Happenings in the MEDITECH & Health IT Community

Silverton Health Engages Summit Healthcare to Streamline Integration Landscape and Connect with Physician Offices as they Prepare for their MEDITECH 6.0 Migration

BRAINTREE, MA, December 20, 2011 -- Summit Healthcare, a leader in healthcare system integration and task automation, today announced a new partnership with Silverton Health in Oregon. In order to enhance overall interface integration and physician office interoperability as they migrate to the MEDITECH 6.0 platform, Silverton Hospital has contracted for the Summit Express Connect interface engine and Summit Provider Exchange for physician office integration.

Volume 7 - Issue 1 - January 2012

Editor's Notes

Customer Spotlight: Holyoke Medical Center Measures Up!

Tricks of the Trade: Unpredictable Result when MEDITECH BAR Index Used by Default

Featured Employer: Sponsored by MeditechCareers.com

Sr. Systems Analyst - Advanced ClinicalsNoyes Memorial HospitalDansville, New York

About the Organization:

About the Location:

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

Sr. Systems Analyst - Advanced Clinicals
Noyes Memorial Hospital
Dansville, New York