News & Information for the MEDITECH Community
Volume 3 - Issue 6 - October 2008

The MEDITECH Community Bulletin is a periodic newsletter covering a broad range of topics that are relevant to the MEDITECH community.  In addition, this newsletter provides a forum for guest contributors including consultants and, of course, MEDITECH customers. The MEDITECH Community Bulletin is published and distributed free of charge to you by Systems Personnel, a professional search firm specializing in the Healthcare IT and Management market.  Visit us online at www.CarrollSearch.com.

If this is the first time you're reading the The MEDITECH Community Bulletin, consider it a warm smile and a handshake as we introduce our newsletter to your company.  If you're a long-time recipient, we hope that you'll find this issue of the The MEDITECH Community Bulletin just as useful as always.

Thanks for your continued ideas, contributions, and feedback!

Regards,
Donna Carroll

QUICK LINKS:  

Customer Spotlight  |  Tricks of the Trade

Featured Employer  |  Recent News  |  Worth a Read  |  Contact Info

Customer Spotlight:  Albemarle Hospital Solving an Integration Challenge

Source:  Summit Healthcare Services, Inc.

INTRODUCTION

In the cozy North Carolina town of Elizabeth City, known as ‘The Harbor of Hospitality,’ residents enjoy an expansive waterfront filled with docks, boat facilities, shops and restaurants.  Coast Guard Air Station Elizabeth City, the largest United States Coast Guard Air Station on the East Coast, is located directly south of the city limits. Residents also are able to take advantage of Albemarle Hospital, one of the area’s premiere full service medical centers.

In addition to providing critical, surgical and comprehensive women’s care to area residents along with a start of the art cancer treatment facility through its Regional Oncology Center, Albemarle Hospital invests heavily in community service programs. The hospital adopts local schools, donates more than 28,000 hours of volunteer time to area organizations and continues to make substantial employee-backed financial donations to the United Way, the American Cancer Society’s Relay for Life and other such area organizations.

CHALLENGE

One of Stephen Clark’s first steps after joining Albemarle Health as its CIO and leader of the Information Technology department over five years ago was to familiarize himself with the hospital’s application landscape. He also wanted to assess operational areas in the facility that needed improvement through internal process modification as well as those areas that could benefit through the implementation of the right integration technology.

One area of integration that immediately caught his eye was the number of Point-to-Point HL7 interfaces running from his MEDITECH HCIS to third party vendors. Although Albemarle Hospital is about 80 to 90 percent MEDITECH in terms of the applications it uses to manage its clinical and financial systems, the organization still had a fair number of disparate systems that needed to exchange data real time. This exchange of data was necessary in order to avoid the error prone and laborious method of manual reentry of patient data into Albemarle’s third party specialty applications.

After learning that Albemarle had a number of the ‘direct’ interfaces coming straight from MEDITECH to each third party application to exchange key information like ADTs, Orders and Results to and from ancillary systems, Clark decided to find an integration method with which to move forward that would meet his short and long-term goals. In addition to researching methods such as application programming interfaces (APIs) and custom interfaces, he wanted to find out more about the benefits of implementing an integration engine to help him better manage the hospital’s existing and future interfaces and an integration partner that could provide Albemarle with the right level of professional services.

After collaborating internally with his peers, Clark knew he needed to invest in an integration engine that would help him achieve his current integration goals but also was built for the future. He wanted to ensure that the solution he chose would support key protocols and services including Web services, SOAP, Windows Communication Foundation (WCF), XML (HL7 3.x) and Flat Files. The solution also needed to have the ability to handle custom requirements for an upcoming Albemarle interface project which required custom components. The State of North Carolina needed an interface with specific data elements that did not exist within his standard HL7 feed from MEDITECH.

SOLUTION

After paring down his list of vendors, Clark chose the Summit Integration Suite from Braintree, Massachusetts-based Summit Healthcare, which provides integration software and solutions that simplify and accelerate the development, deployment, and integration of healthcare applications. The Summit Healthcare product line delivers a distributed, costeffective, easily managed platform that reliably integrates applications, automates workflow and simplifies business processes across the healthcare enterprise.

The Summit Integration Suite is used to support clinical integration between Albemarle Hospital’s MEDITECH HCIS and its third party applications for facilitation of rapid access to crucial healthcare information for the hospital’s clinical decision makers. Including the Summit HL7 Adapter, which is powered by Microsoft BizTalk Server, and the Summit Scripting Toolkit solution, the integration suite from Summit Healthcare had all of the necessary components Clark needed to manage and develop interfaces in one, easy-to-use application.

The Summit HL7 Adapter carried the ability to eliminate Albemarle Hospital’s redundant Point-to-Point interface and had a dashboard component that would enable his team to effectively monitor his critical 24 x7 interfaces from any location. The Summit Scripting Toolkit (SST) component of the suite would help him avoid spending significant customization dollars for the State of North Carolina project because he could use the solution to extract the required data that wasn’t included in the standard MEDITECH interface feed. In addition, Clark could leverage SST’s workflow automation functionality as a process improvement tool throughout his enterprise by eliminating redundant tasks like data entry between systems (billing, budget, clinical, price increase uploads and more).

"When we originally selected Summit Healthcare as vendor of choice, reducing our total cost of ownership (TCO) was as equally important to me as finding a mature integration partner like Summit Healthcare who could provide feature rich integration products as well as value added expert services such as Integration Outsourcing," explained Clark.

"Albemarle’s implementation of the Summit Integration Suite is a prime example of how Summit Healthcare’s proven technology can make a resounding impact to the clinical and financial environment of a healthcare organization," added Jim McKinnon, Executive Vice President of Summit Healthcare.

Because of his limited in-house IT resources, Clark decided to participate in Summit Healthcare’s Integration Outsource program, in which he could hand over the interface construction, implementation and support to a cast of seasoned engineers without compromising his return on investment (ROI) goals. After identifying to his staff the benefits of implementing Summit’s Integration Suite, Clark performed an analysis of the total cost of the ownership investment and a forecasted ROI for Albemarle for the next five years. His ROI plan stated that, within five years, Albemarle Hospital would achieve a solid net ROI gain of approximately $200 thousand dollars.

Albemarle Health awarded Summit Healthcare with the project and the timeline goals were set. Within a short period of time after implementation, Stephen and his team were able to start feeling the positive effect of their investment, specifically reduced maintenance fees and interfaces that ran smoothly.

"It is essential for progressive healthcare organizations like Albemarle Hospital be able to provide the right integration technology to achieve fast ROI while promoting easier collaboration among doctors and facilities as well as to improve business processes (human/fax workflow) without the need to increase staff," explained McKinnon.

BENEFITS

Five years after first implementing the Summit Integration Suite, Clark reviewed his original ROI plan and was thrilled to find out that as a result of his decision to implement the solution, Albemarle had more than doubled its ROI goals at almost $500,000.

"I am extremely pleased at the outcome of our investment in the Summit Integration Suite," remarked Clark. "I had projected that within five years, Albemarle Health would have a net ROI gain of approximately $200K by reducing the number of point-to-point interfaces we manage. However the true number turned out to be over $500,000 once I factored in other impacting variables like maintenance cost of existing point-to-point interfaces and reduced IT resources that may have been required to develop new code."

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Tricks of the Trade:  Writing Readable MEDITECH NPR Macros (Part 1 of 3)

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

Readable code costs less than code that is hard to read. If you can’t read the code, you can’t easily identify: errors in logic (aka bugs), ways to reorganize it or change it to meet enhancement requests. Readable code on the other hand allows you and your programmers to understand and repurpose the code. Let’s say that you get a new report request this morning, if your NPR report dictionary is full of unreadable code, you’ll likely write the new report from scratch. New code can mean programming the same types of routines over and over unnecessarily and worse … new bugs. If your reports are written in a readable format, you will no doubt, check them first and copy the reusable, common routines into the new report.

One thing that contributes to unreadable code is the standard DO Loop; almost every NPR macro has one. By using the technique below, you’ll improve the readability of a large percentage of your NPR reports.

Let us examine a standard DO Loop. Notice the code runs off the page. You can’t just open the macro, read the code and move on. This is not readable code.

Examine with me the Reverse DO Loop. If this is your first look at a Reverse DO Loop, it takes a little getting used to, before you can read this in a second or two. Learning to read a Reverse DO Loop is a skill and therefore something you grow more comfortable with as you do it. Reference this article: http://comstock-software.com/blogs/npr/2008/08/npr-do-loops.html for the detailed walk thru on a Reverse DO Loop.

By writing readable code, you’ll be more productive and your MEDITECH users will love you for your responsiveness to their needs. Keep learning. Your new level of productivity is the new standard that will be expected from now on.

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

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Featured Employer:  FREE Job Advertising

Every month, we feature one employer and allow them to advertise their job posting in our newsletter FREE of CHARGE.  The featured employer will also have their job advertised on our MeditechCareers.com web site.  If you're interested in getting your job advertised for FREE, simply email us the job description, along with your full contact information, and we'll contact you for additional details.

Providence Health & services
Burbank, California

About the Organization:
Providence Health & Services is a not-for-profit health system committed to providing a comprehensive array of services to meet the needs of communities across five states, including Alaska, Washington, Montana, Oregon and California. Providence continues the legacy of the Sisters of Providence and the Sisters of the Little Company of Mary in the West spanning more than 150 years.

Providence Health & Services includes 26 hospitals, more than 35 non-acute facilities, physician clinics, a health plan, a liberal arts university, a high school, approximately 45,000 employees and numerous other health, housing and educational services. The system office is located in Seattle, Washington.

Providence Health & Services in Alaska, Washington, Montana and Oregon is sponsored by the Sisters of Providence religious community. In Southern California, the health ministry is cosponsored by the Sisters of Providence and the Little Company of Mary. Providence Health & Services has won many awards and recognitions from national and local organizations. We are especially proud of to achieve magnet status at Providence Holy Cross Medical Center, the first community hospital in Los Angeles County to receive such a prestigious designation. Providence Health & Services is also considered one of the top employers in the nation.

About the Location:
There’s a reason California is still called the Golden State. Sunny weather and the exciting pace of life have made this state the biggest draw in the West. Our five hospitals are all located near outdoor fun and interesting places to visit. The minitries located in Torrance and San Pedro are 15 minutes from the Pacific Ocean, where residents enjoy an average temperature of 72 degrees. Many outdoor activities are enjoyed all year long. The Ministries to the north is located near Los Angeles, home to many attractions, including Universal Studios, Hollywood, The Getty Center, and the Los Angeles Theatre District. Sports enthusiast can take in Los Angeles Lakers basketball, Kings hockey and Dodger baseball.

About the Department:
The Information Systems Department for Providence Health & Services, California Region, provides Information Systems support to 5 hospitals and multiple clinics within the Southern California area. Our department is in the process of bringing support of the Meditech system back in house, and is looking for experienced Sr Applications Analysts to support the current implementation, and expanded use of the system as we move forward in optimizing the use of the Meditech system at our facilities. We currently have 20 Meditech modules installed, and need staff to support all aspects of the system. The Meditech implementation is standardized regionally, and projects are identified for implementation of BMV, CPOE, Document Imaging, Data Respository, as well as many other non-Meditech projects.

Current Position(s) Available:

Sr. Clinical Applications Specialist - MEDITECH
Permanent, Full-Time

Description:
We are currently seeking full-time Senior MEDITECH Applications Specialists for our Information Systems Department. This position performs systems analysis functions, project management, and modification of the clinical systems application software. Core responsibilities:

• Demonstrates Providence Health & Services – California Region core values of respect, justice, compassion, and excellence to customers, employees, and visitors; and provides quality service in the performance of work assignments and duties.

• Maintains established departmental policies and procedures, objectives, improving organization performance program, and safety standards.

• Analyzes client's needs regarding new or enhanced systems applications/software.

• Maintains and modifies application software and packages via vendor's engineering releases and utilities.

• Evaluates and documents current manual and/or automated systems in preparation for system conversion, initial implementation, or maintenance.

• Establishes acceptable action plans for application software projects, recommends team members and assigns responsibilities.

• Designs and documents general functional requirements and detailed technical specifications for application software consistent with Regional Standards and departmental policies.

• Ensures data integrity through interaction with financial and outcomes systems and auditing verification. Complies with and supports enforcement of confidentiality of protected health information policies at all times.

• Tests new and/or modified applications software in accordance with established acceptance criteria.

• Installs and implements application software in an optimal manner to minimize the effect on production and development activities. Complies with departmental change management processes at all times.

• Provides effective direction to project team members, or other staff members, and assists in coordinating activities including Project Management.

• Interacts with users and clients through various phases of analysis, design, implementation, and maintenance.

• Communicates with managers and staff project status and operational changes as appropriate.

• Ensures clients are trained on new enhancements.

• Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.

• Attends meetings as required, and participates on committees as directed. Represents the IT department in a professional manner at all times.

• Performs other duties as assigned or requested.

Qualifications:

• Bachelor's degree, or equivalent related training

• Clinical healthcare background/license (RN or other health related) preferred

• 5+ years of experience with clinical systems applications/software required

• MEDITECH clinical systems applications support highly preferred

Working Conditions:

• Occasionally subjected to irregular hours

• On-call rotation required

How to Apply:
To apply for this Job, please apply online and search for requisition numbers 41809, 41810, 41811.

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Other Featured Employers on MeditechCareers.com

Please visit MeditechCareers.com to view all of our Featured Employers.
Current opportunities exist with the following organizations.

POSITION:	EMPLOYER:	LOCATION:
Application Analysts	Alice Peck Day Memorial Hospital	Lebanon, New Hampshire
MEDITECH Analyst	Centura Health	Englewood, Colorado
Sr. Business Analyst - Clinical Applications	Halifax Health	Daytona Beach, Florida
MEDITECH Services Specialist	Interface People	Lewisville, Texas
MEDITECH Clinical Systems Analyst	Ministry Health Care	Rhinelander, Wisconsin
Several MEDITECH positions	New England Baptist Hospital	Boston, Massachusetts
Several MEDITECH ppportunities	Systems Personnel	Various U.S. Locations

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Recent News:  Iatric Systems Ranks Among America’s Fastest-Growing Private Companies According To The 2008 Inc. 5000 List

Broad healthcare information systems experience and exceptional customer service drives Iatric Systems’ strong growth; Inc. magazine ranks company among Top 100 in Boston region

BOXFORD, MA--September 29, 2008.  Iatric Systems, a leading provider of integrated software applications, interfaces and reporting solutions for Healthcare Information Systems, is one of America’s fastest-growing private companies, according to the 2008 Inc. 5000 list. The annual Inc. review also ranked Iatric Systems among the Boston region’s top 100 private companies.

The Inc. 5000 list is published annually to recognize privately held U.S. companies that demonstrate outstanding growth during a four-year period. Iatric Systems revenues grew more than 140 percent from 2004 through 2007, which ranks the company 2,602 nationally and 95th within the “Boston-Cambridge-Quincy, MA-NH” region.

"Iatric Systems is thrilled to be recognized by Inc. magazine as one of the country’s fastest-growing private companies and among the Top-100 businesses in the Boston area,” said Joel Berman, founder and president of Iatric Systems. “Iatric Systems offers exceptional customer service, customer listening-based product development and a worldwide workforce including former hospital management, IT managers, RNs, pharmacists, lab techs and others who deliver focused and practical solutions to our customers. Our team’s deep real-world hospital expertise sets Iatric apart; it’s the core of our growth strategy and the reason for Iatric Systems continued success.".

Joe Walsh, senior manager of information systems at Cape Cod Healthcare concurs, "Customer service is what differentiates Iatric Systems from all other Partners. It’s the hallmark of the company and it’s always a pleasure to share our experiences with other hospitals."

Iatric Systems’ 18-year track record of success provides customers with the assurance of organizational stability, which is critical in the HCIS industry.

Visit www.inc.com/inc5000 for the complete Inc. 5000 national list and top 100 businesses in the “Boston-Cambridge-Quincy, MA-NH” region.

About Iatric Systems
Since 1990, Iatric Systems has been helping hospitals and health systems leverage their HCIS investment by providing innovative software, interfaces and reporting services; most notably for the MEDITECH HCIS. More than 800 hospitals and health systems worldwide have implemented Iatric Systems’ solutions in order to optimize patient care and improve workflow efficiencies in clinical, financial and administrative areas. Iatric Systems is committed to providing solutions with exceptional value backed by outstanding customer service. For more information about Iatric Systems, its products, and its services, visit www.iatric.com.

More info:  http://www.businesswire.com/portal/site/home/permalink/?ndmViewId=news_view&newsId=20080929005367&newsLang=en

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Recent News:  Iatric Systems to Sponsor "FOCUS on 6.0" Seminar

Iatric Systems will be sponsoring a free one-day seminar on Wednesday, October 15th regarding migration to FOCUS 6.0. Sessions include:

MAGIC to FOCUS - What's the Scoop? Doylestown Hospital went live with FOCUS on May 1, 2008. Carol Muhlbauer, Senior Manager of Clinical Applications at Doylestown, will update her International MUSE presentation with the latest scoop.

The Wayne Memorial Hospital Experience: Wayne Memorial is a MAGIC site in the midst of their FOCUS migration. Lori Cole, Director of IT at Wayne Memorial, will review why the hospital chose to migrate, how they are overcoming challenges and what they are discovering along the way.

CIO Panel and Open Discussion: Bring your thoughts, concerns and all of your questions to this session - we'll be prepared for audience participation! CIO panelists from three additional sites will facilitate this lively session and provide an overview of each hospital's perspective on migration to FOCUS.

Hocus, Pocus! More MAGIC Behind FOCUS: Iatric Systems has had an opportunity to work on FOCUS at several sites. This session will give attendees a basic technical understanding of MEDITECH's newest proprietary platform.

The seminar will be held on Wednesday, October 15th at Hilton Baltimore BWI adjacent to Baltimore / Washington International Airport (BWI). For those able to drive to the event, sessions begin at 10:00am and end at 3:30pm to help minimize rush hour traffic concerns. Please request our FAQs brochure to learn how to obtain the best hotel room rates.

More info:  http://www.iatric.com/about/news_detail.asp?id=173

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Recent News:  Summit Healthcare Teams with mTuitive to Standardize Cancer Reporting Across Laboratories in Meditech Hospitals

BRAINTREE, MA--August 12, 2008.  Summit Healthcare, a leader in enabling system integration for the healthcare industry and provider of healthcare integration products and services, has teamed up with mTuitive to connect its scripting interface with the company’s xPert for Pathology synoptic reporting solution for use with Meditech’s Magic and Client Server pathology modules.

Four Meditech hospitals have recently gone live with the collaboration, which standardizes cancer reporting across the facilities’ laboratories while providing a seamless user experience and reliable data submission. Ontario hospitals Thunder Bay Regional Health Sciences Centre, The Scarborough Hospital, Rouge Valley Health System and Lakeridge Health recently went live with the technology and are currently reporting all their cancer cases synoptically in accordance with Cancer Care Ontario’s new College of American Pathologist/Collaborative Stage-Aligned data standard.

Three additional hospitals with implementations under way include Peterborough Regional Health Centre, University of California Davis Medical Center and Cape Cod Hospital (MA).

"mTuitive has been a very valuable tool recently added to our pathology practice," remarked Dr. Joseph Wasielewski, Chief of Pathology at Thunder Bay Regional Health Sciences Centre. "It allows us to report on cancer parameters in the most up to date and standardized way to facilitate appropriate patient management."

"We are very pleased that mTuitive has utilized the Summit Healthcare’s Integration Technology to assist their client’s with transferring data from their pathology practices to multiple backend systems. This initiative has ensured that all critical patient data is available and accessible to all authorized care providers," states Tara Marchi, Marketing Manager, Summit Healthcare.

Cancer checklists, in synoptic format, will enhance the quality of pathology reporting across the laboratory by ensuring that reports contain all of the relevant clinical information required to make informed patient care decisions. “Synoptic format” involves gathering data items in a structured, standardized format and layout with a pre-specified choice of responses. Information is then stored as discrete data elements.

About mTuitive
mTuitive, Inc. develops data capture and synoptic reporting software to assist health care professionals in recording clinical findings and maintaining compliance with established protocols and guidelines. Our unique method of capturing structured information provides valuable data for pathology, oncology, and cancer staging applications. Established in 2003, mTuitive, Inc. is based in Massachusetts. See us on the Web at www.mtuitive.com.

About Summit Healthcare
Established in 1999, Summit Healthcare is a leading integration company recognized as a thought leader on advanced integration technologies and cost effective strategies. For the past 10 years they have worked to meet their clients’ challenges and refine their development efforts to create one cohesive technology environment. In 2008 Summit Healthcare introduced Apex08, an integrated core of products developed to meet all of your integration needs. Product highlights include Scripting Toolkit, Downtime Reporting, Dictionary Synchronizer, Interface Engine and HL7 Adapter. Whether you need a simple data script or enterprise integration solution, Summit has the answer. The company has more than 750 healthcare clients and thousands of users as well as close partnerships with complementary technology vendors, major system integrators, and value-added resellers. For more information, visit www.summit-healthcare.com.

More info:  http://www.summit-healthcare.com/index.php?option=com_content&task=view&id=488&Itemid=284

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

Building a Warehouse
By:  David Raths
HealthCare Informatics, August, 2008

The emphasis on the warehouse of data is missing the most productive piece. The tools to mine the data effectively are giving executives and providers the tools they need to make good decisions. Who needs to be involved and who is accountable for that data across disparate systems? A strong mix of IT, executive support and clinical informatics involvement is needed.
Read article

The Final Hurdle
By:  Daphne Lawrence
HealthCare Informatics, August, 2008

The final part of a three-part series on medication administration, this article examines the points where errors are most likely to be made.
Read article

A Shift in Staffing
By:  Kate Huvane
HealthCare Informatics, July, 2008

Can you make your clinicians happier using a web based self scheduling system? The facilities that made the transition from paper to just this type of system are reporting not only greater clinician satisfaction, but better patient throughput and a reduction of costs.
Read article

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