Volume 4 - Issue 8 - November 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:

• Our Customer Spotlight column discusses MEDITECH's Clinical Review application.  The MAGIC of Clinical Review: A logical progression toward CPOE is a must-read article for all MAGIC sites considering the use of Clinical Review and CPOE.

• John Sharpe of Comstock Software is once again sharing his wealth of NPR knowledge in our Tricks of the Trade column.  In addition, John is offering a free webinar about "Microsoft Excel - Fundamentals for MEDITECH Reports" on Friday, November 13th at 3:00 p.m. Eastern.  To receive your webinar invitation (to be sent out on November 11th), simply sign up for John's MEDITECH Reports Blog newsletter.

• New Advertisers! We welcome two new advertisers to our newsletter this month: ProVation Order Sets by Wolters Kluwer Health; and HLStandards.com by Corepoint Health.  Check out their ads above, and visit their sites for more information.

• All information and content for the December issue of The MEDITECH Community Bulletin must be received no later than Wednesday, November 25th. Thank you.

I wish you all a very happy, healthy, and bountiful Thanksgiving!
Donna

Customer Spotlight: The MAGIC of Clinical Review: A logical progression toward CPOE

By: Donna Carroll, VP , Systems Personnel

A must-read article for all MAGIC sites considering the use of Clinical Review

MEDITECH's Clinical Review application can be a wonderful tool for your healthcare providers. Using Clinical Review can result in higher physician productivity, improved patient safety, and better preparation for CPOE. But, does your staff have the time and expertise to implement it properly?

A Primer on Clinical Review:

Clinical Review is an application used by MEDITECH MAGIC sites that provides physicians with a real-time, dynamic view of patients’ clinical information. It displays data based on pre-defined, standardized data mappings which format the data into easy-to-read panels organized by type, specifically:

• Laboratory, Microbiology, Blood Bank, Pathology
• Medications
• Radiology exams
• Reports from Departmental or Physician Documentation
• Notes and Assessments from NUR and EDM
• Vital Signs and Intake & Output queries
• Other queries that are part of a Special Panel

Clinical Review has a similar layout to the Client Server EMR application with interactive panels. The display of data allows providers to easily review a patient's clinical data sorted by department, date, time, or data item, making it easier to navigate through and to analyze data.

Additionally, Clinical Review is utilized by the following applications:

• Physician Desktop and Workload Management (PWM): The Clinical Review and Physician Desktop applications work together in providing the physicians with improved workflow from sign-on, rounding, to viewing data, as well as from electronic ordering to discharge.
• Physician Documentation (PDOC): The clipboard functionality of Physician Documentation copies results from Clinical Review directly into patient documentation.
• Emergency Department Management (EDM): Assessments, tests, products, orders, procedures, notes and reports entered in EDM are transferred directly to Clinical Review.
• Internet Access for Doctors (IAD): Physician Internet Gateway relies on Clinical Review to display results in an XML format

How do we know if we’re ready for Clinical Review?

The fact that you’re asking the question probably means that you are ready. If you have any plans to utilize MEDITECH’s Physician Desktop and Workload Management (PWM) or Provider Order Management (POM, a.k.a. CPOE) applications in the future, then implementing Clinical Review is a logical progression toward that goal. Getting your physicians accustomed to navigating MEDITECH to access patient data will help prepare them for the transition to the Physician Desktop or CPOE.

If your organization is LIVE with the 5.6 update or currently have the PCM or EDM suites installed, then you are eligible to install Clinical Review. All sites on release 4.9 or later should already have the EPS (Extra PCI Source) database which is used to populate the Clinical Review application.

Installing Clinical Review requires that the EPS module be on a server-class machine and should be the only application on the server. Clinical Review also runs on fairly large memory structures, so this machine may require significant disk space and an ample supply of RAM. It is recommended that the server should be a fast OSAL machine with 8kb blocks. Additionally, utilizing Clinical Review will require use of the 4.x workstation.

How will we benefit from using Clinical Review?

There are many benefits to using the Clinical Review application, including:

• Real-time dynamic views of patients' clinical data
• Data standardized with pre-defined EMR ID mappings
• A Windows look-and-feel with ability to use mouse navigation
• Streamlined navigation and integration with Advanced Clinical modules
• Clinical Review is a non-purging application which actually stores the data

The above benefits are directly related to the day-to-day use of the Clinical Review application, but it’s equally (if not more) important to take a look at the big picture. It’s a fact: the ability to gain physician adoption of CPOE is directly related to the state of organizational readiness for the deployment. Many variables factor into physician acceptance of CPOE, including the communication plan, end-user training, and go-LIVE support. However, one of the easiest ways to prepare your physicians for CPOE is to get them accustomed to the daily use and navigation of the system to access detailed patient data, such is available to them via the Clinical Review application.

In addition, when Physician Desktop is used in conjunction with Clinical Review, the applications can have a significant impact on patient safety and quality. Physicians are able to see critical values through Clinical Review, and receive notifications immediately upon signing into Physician Desktop. Together these applications consolidate access to most commonly-used functions onto a single screen, enabling providers to manage their patient populations more efficiently and to prioritize tasks.

This all translates into a more rapid return on investment (ROI) on your CPOE implementation, more efficient and productive physicians, and improved patient safety.

How can our EPS mapping be accomplished more efficiently?

The display of data in the Clinical Review application depends upon data mappings from EPS to specific data items, called EMR IDs. Every single data item must be mapped in order for that data to flow to Clinical Review. This mapping process requires not only a considerable amount of time to complete, but also takes a certain degree of ramp-up time to get started.

If you’re like most facilities today, you understand that time is a precious commodity. With one more project on your plate, you may be wondering, “What is the most efficient way to accomplish our EPS mapping?” One thing you should carefully consider is whether the time your in-house staff spends on this project is an acceptable trade-off for the time stolen from other critical tasks. A typical application analyst spends their average day evaluating issues and re-prioritizing items in order to focus their attention on the most critical needs. This constant juggling of tasks will inevitably push Clinical Review lower and lower on their task list. Before you know it, the Clinical Review project has found its way back on the shelf waiting for the rainy day that never comes.

This is where we can help! We have a team of consultants with extensive EPS mapping experience who have refined the mapping process to establish a proven method for success. Due to this prior experience, we’ll be able to complete the mapping in far less hours than your in-house staff would be able to. Also, utilizing our team of consultants helps to ensure data consistency throughout the mapping process.

In addition, the EPS mapping process does not require our consultants to be at your site to perform the job. This translates into cost-savings for you since there will be no travel required. In fact, working remotely actually boosts productivity since there are none of the typical distractions of a hectic office environment.

After an initial consultation and dictionary review, we will provide you with an approximate time estimate to complete the mapping process. This will allow you to budget the project more accurately, and to plan your end-user training accordingly. We provide you with status reports on the mapping progress so that you can track the project effectively. When you consider all of the benefits, outsourcing your EPS mapping to our team of experienced professionals just makes great sense!

To learn more about how Systems Personnel can assist with your Clinical Review implementation, please give me a call at 413-569-1111. We look forward to working with you! Regards, Donna.

Tricks of the Trade: MEDITECH NPR (Client Server) - Clean Code (Part 1 of 3)

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

NPR reports usually start out simple. You place a few fields on the report. And roll it out to the end users. After the report has been in use for a while, someone requests a change. This time, you implement the change using a custom field. And as time goes on, the report becomes more complex and a macro evolves. The macro begins as a few lines, and the next thing you know, the code can begin to look like this.

As you looked through this example, you noticed that the majority of the code looks the same. Removing the repeated code, also known as de-duplicating the code, will make your life easier when that next change request comes through.

Some of the most popular tools at our disposal for de-duplicating code - are sub-routines and parameters. Using these mechanisms will allow us to separate the information, in this case query and section, from the code that retrieves values from the MEDITECH database.

Let’s talk more about sub-routines & parameters. Sub-routines work best as well named blocks of code that do one thing well. You give a sub-routine a job; it completes the task and returns. For the sub-routine do to its job, some information may be necessary to perform that job. The parameters are used to communicate the information to get the job done.

Example:

The sub-routine in this example is SUM_NUMBERS. To return with the sum of 2 numbers, the parameters A & B are used to communicate the numbers to be added. While MEDITECH macros do not support parameters for sub-routines in the traditional way:

You can achieve the same thing in a MEDITECH macro like this:

Moving on from this example, let’s apply the technique to the code below. The VITAL.REPORT sub-routine receives the “VS.PULSE” & “HR” parameters and then reports on these values from the MEDITECH database. As you can see - “VS.PULSE” & “HR” are passed on to td.query & /SECTION. The parameters are used by the sub-routine to retrieve the PULSE value, to determine the documented HEART RATE for the patient.

Later down the road – the query may change, or another query may need to be added. Because you’ve organized this macro, another report writer, one with less experience than you, might be able to come in and add a couple of queries to the HR section in a timely manner.

Questions? Get them answered at the MEDITECH Knowledge Exchange.
Thoughts? Email them to John at jsharpe@comstock-software.com.

 

FREE WEBINAR

Microsoft Excel - Fundamentals for MEDITECH Reports

When: Friday, November 13th at 3:00 p.m. Eastern.

Where: Sign up for the MEDITECH Reports Blog newsletter. Invitations to this webinar will be sent out Wednesday, November 11th.

 

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 & Consulting"

About the Organization:

Systems Personnel is a professional search & consulting firm specializing in the Health IT, Management, and Sales fields. With 20 years of success in the search industry, our commitment to excellence is demonstrated by the numerous awards we've earned in the world's largest recruiting network. We are also members of the Healthcare Information and Management Systems Society (HIMSS), and the Capital Area Roundtable on Informatics in Nursing (CARING).

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

• Permanent Placement
• Consulting Services:
  • Business & IT Consulting
  • Staff Augmentation
  • Interim Management
• Temp-to-Perm Hiring

Opportunities Available:

Below are some of the numerous Health IT searches we are currently performing for our clients.

• MEDITECH LIS Coordinator -- permanent position in eastern Texas.
• MEDITECH / Siemens Soarian Integration Tester -- contract in eastern Massachusetts
• CBORD / MEDITECH Integration Consultant --contract in eastern Massachusetts.
• MEDITECH PDOC Builder -- contract in eastern Massachusetts.
• MEDITECH POM Builder -- contract in southern Florida.
• MEDITECH Consultants -- contracts in southern California: 1) Meditech-EMPI Strategy PM/Strategist – experience w/ Initiate’s product; 2) ICD10-5010 Project Coordinator; 3) CPOE Project Managers; 4) CPOE Physician - Adoption Leader.
• CLOVERLEAF Interface Developer -- 1-year contract in northern Florida.
• EPIC / Beacon Oncology Builder (Pharmacist/Tech) -- 6-month contract in southern New Hampshire.
• EPIC Analyst -- Temp-to-perm hire in Texas. Must be EPIC Certified in OpTime or ASAP; must have experience with CPOE Builds, Completing Orders, Smart Tools, Smart Text, and Smart Forms.
• ECLIPSYS SCM 5.0 Consultants -- contracts in southern California: 1) EMAR/Clinical Documentation; 2) Emergency Department Implementation; 3) Core Builder.
• PARAGON Financial Consultant -- permanent position in the Southeast.

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: The Times They Are A'Changing

MEDITECH's Physician/CIO Workshop gives health care leaders a platform for discussing industry changes, present and future, as well as sharing I.T. strategies for long-term success.

WESTWOOD, MA (November 6, 2009) -- Health care is never stagnant, but in recent years, change has become the rule instead of the exception. And there is no end in sight; from evolving government standards, to a dwindling physician population, to mounting cost pressures and a looming chronic disease crisis—hospitals are facing changes of unprecedented magnitude, which in turn will spawn more changes affecting virtually every area of our industry. It is a transformative time for all health care leaders, and physicians in particular, as we struggle to find ways to adapt in the midst of ever-expanding challenges and consumer expectations.

MEDITECH's 2009 Physician/CIO Workshop gave our customers a chance to discuss these widespread changes, as well as exchange strategies with other health care organizations about how to use I.T. in smarter, more creative ways, to navigate the uncertainties we are all facing. MEDITECH's COO and President Howard Messing opened the conference by marvelling at how much technology, as well as the world in general, has changed since our founding over 40 years ago.

Read article...

Recent News: Dell Completes Tender Offer for Perot Systems

ROUND ROCK, TX (November 3, 2009) -- Dell today announced the successful completion of its tender offer for Perot Systems, an offer which expired Monday at midnight (EST). Dell has accepted the shares validly tendered and has notified Perot Systems of its exercise of its top-up option to acquire Perot Systems shares. As a result of the tenders and the top-up option exercise, Dell will own more than 90 percent of outstanding Perot Systems shares and expects to promptly complete the acquisition of Perot Systems, significantly expanding Dell’s portfolio of technology services and business solutions. The 108,774,629 tendered shares represent about 87.7 percent of outstanding Perot Systems shares. An additional 3,961,266 shares were tendered by notice of guaranteed delivery.

Dell Services, a new business unit formed by the acquisition, will develop and deliver a best-in-class suite of end-to-end IT services and business solutions that reduce IT complexity and lower costs for customers. The integration of Perot Systems extends Dell Services into hosting, consulting, applications and business-process outsourcing, and expands Dell’s existing managed and modular services. The combination leverages Perot Systems’ capabilities across Dell’s much larger customer base, spanning global corporations, government agencies, health care and educational institutions, and small and medium enterprises.

Read article...

Recent News: Initiate Systems Acquires Accenx

Initiate Offers Healthcare Communities Interoperability and Connectivity with the Addition of Accenx Exchange™

CHICAGO, IL (October 30, 2009) -- Initiate Systems, Inc., a leader in data management solutions for information sharing and improved data quality, has acquired Accenx Technologies, Inc., a leading provider of health information exchange solutions. This acquisition furthers Initiate’s growth strategy and expands its offerings in the healthcare market. The terms of the deal are confidential.

By acquiring Accenx, Initiate expands the breadth and reach of its proven interoperable health solutions enabling a broader set of healthcare stakeholders to connect and share information as market dynamics require greater focus on establishing well integrated healthcare communities.

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Recent News: MEDITECH Prepares You for ARRA with Our Continuity of Care Document Exchange Suite

WESTWOOD, MA (October 28, 2009) -- By 2011, health care organizations must be able to produce and share an electronic summary record for every transition of care in order to receive maximum stimulus funds from the American Recovery and Reinvestment Act (ARRA). MEDITECH is pleased to announce the availability of our Continuity of Care Document (CCD) Exchange Suite, which allows customers to access and exchange patient medical summaries in accordance with current industry standards when used with our 6.0 and Client/Server and MAGIC 5.6 applications.

The CCD Exchange Suite of interfaces allows MEDITECH's Health Care Information System to receive and display CCD documents from non-MEDITECH systems, and to compile and send a CCD document as a response to requests from other vendor systems or a Record Locator Service. The interfaces are based on the HITSP C32 specification, and communication messages support the IHE XDS Medical Summary Profiles.

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Recent News: Corepoint Health Adds Key Operational Features and Enhances Native High Availability Support in Corepoint Integration Engine

Corepoint Health Continues to Advance the Industry-Leading Interface Engine Platform to Streamline IT Infrastructure Costs and Further Productivity Gains in Configuring and Managing a Healthcare Integration Environment

PLANO, TX (October 26, 2009) -- Corepoint Health is continuing to lead the new integration generation with the Fall Release of the most advanced, innovative integration platform – Corepoint Integration Engine. The Fall Release includes the following highlighted enhancements and features:

• Unique, new HL7 testing features which enable quick identification of message differences and changes
• Further X12 support by adding version 005050
• Expanded native high availability functionality centered on expanding monitoring and management capabilities
• Enhanced log management performance, including compressed storing of files to save disk space

"Corepoint Health is my security blanket in the big, complex world of healthcare integration. With their solution, I have insight to what is really happening between various healthcare vendors, and we can implement interfaces in a timelier, more independent manner," said William Smith, Application Manager at Atlantic General Hospital.

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Recent News: Certification Commission Launches 2011 Certification

CCHIT Certified® and Preliminary ARRA Programs Now Available

CHICAGO, IL (October 7, 2009) -- The Certification Commission for Health Information Technology (CCHIT®) announced that it opened applications for new certification programs today as planned. In addition to an updated Comprehensive electronic health record (EHR) certification program, called CCHIT Certified® 2011, the Commission is offering a modular certification program called Preliminary ARRA 2011 that is limited to the standards for qualifying EHR technology under the American Recovery and Reinvestment Act (ARRA). Complete information about these programs, their requirements and the application is available at http://www.cchit.org/get_certified.

“Our decision to move forward instead of waiting has been met with a very positive response,” said Alisa Ray, CCHIT executive director. “The ‘Get Certified’ workshop on October 1 exceeded our attendance expectations, drawing over 310 people, with strong interest in both programs.  Today, we are opening both of our 2011 programs for certification applications from vendors and developers.”

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Recent News: Vocollect and Boston Software Systems Announce Strategic Partnership

Automation Technology Improves Accuracy of Patient Records, Quality of Care, Productivity

PITTSBURGH, PA and SHERBORN, MA (September 14, 2009) -- Vocollect, Inc., the global leader in voice technology and Boston Software Systems, the leader in workflow automation to the healthcare market, today announced a strategic partnership.  Under the agreement, Vocollect will use Boston WorkStation™ automation technology to enable AccuNurse® voice-assisted care to seamlessly integrate with MEDITECH and other leading health care platforms. As a result, nurses cut down on paperwork, improve accuracy of information into MEDITECH and gain more quality time with patients.

Butler Memorial Hospital, a community hospital located in Butler, Pennsylvania, recently piloted AccuNurse voice-assisted care with its IV nursing team, and is now in the process of fully implementing the technology. The MEDITECH interface, which was developed in conjunction with the pilot project at Butler Memorial Hospital, is now available to other MEDITECH sites.

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Recent News: maxIT Assists Medical Center to Achieve Prestigious Stage 6 Recognition

GRMC is number one in New Mexico and among the top one percent of healthcare organizations in North America to achieve Stage 6 of 7 in the MEDITECH EMR Adoption Model.

WESTFIELD, IN (August, 2009) -- maxIT Healthcare, LLC (maxIT), a leading professional consulting services company for healthcare pro¬viders, announced the successful “Stage 6” designation of Gila Regional Medical Center (GRMC), a 68-bed, not-for-profit, county-owned hospital located in Silver City, New Mexico. maxIT assisted the Phoenix Health Systems client by providing GRMC with experienced MEDITECH IT consultants to support the implementation of several HIS modules. Beginning with an operations assessment, maxIT assisted GRMC with a major systems upgrade and Phoenix Health Systems hosted the data center relocation effort. Immediately following the systems upgrade, Phoenix and maxIT collaborated with the hospital staff and physicians to put together a remediation plan that provided the appropriate guidance and action required to reach this outstanding accomplishment. GRMC has become one of the most recent hospitals to achieve Stage 6 on the HIMSS Analytics EMR Adoption Model.

According to David Furnas, Chief Information Officer at GRMC, “We are delighted to continue our commitment of improved care delivery, enhanced patient safety, and increased efficiency to our community. Becoming a Stage 6 hospital and the benefits of a virtually paperless medical record environment, demonstrates our willingness to invest in the types of technology enhancements that ultimately provide better value for our patients.” Mr. Furnas continued, “Phoenix’s help and maxIT’s involvement was instrumental in getting us through a major system upgrade, as well as remediation and implementation assistance that have helped us across the finish line. We are pleased with their level of knowledge, leadership, and clinical experience that made working with maxIT a very enjoyable experience.”

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