August 26, 2014, 4:18 pm

healthsystemCIO: Bernie Clement, CIO, Thibodaux Regional Medical Center, Chapter 3

Any CIO worth his or her salt knows the importance of getting physicians engaged; the big question is how to do it. In his three years at Thibodaux Regional, Bernie Clement has learned that there is no easy solution, but if you want to get clinicians on board with change, you have to seek input when designing processes and implementing systems, be transparent, and be patient — eventually they’ll see “the light at the end of the tunnel.” In this interview, Clement talks about how his relationship with Meditech has improved, the work his team is doing with analytics, and why some vendors just “get it.” He also discusses his career path, the most challenging — and rewarding — aspects of being a CIO, and why you’re only as good as the organization you work for.

Chapter 1

Chapter 2

Chapter 3

  • Director of strategic planning — “It was nice to use the other side of my brain”
  • The CIO’s toolkit
  • Taking a job closer to home
  • Getting — and staying — lean
  • From the oil industry to health IT
  • Applying project management skills
  • Toughest part about being a CIO

Read more or listen to the podcast at healthsystemCIO.com.

August 26, 2014, 4:11 pm

healthsystemCIO: Bernie Clement, CIO, Thibodaux Regional Medical Center, Chapter 2

Any CIO worth his or her salt knows the importance of getting physicians engaged; the big question is how to do it. In his three years at Thibodaux Regional, Bernie Clement has learned that there is no easy solution, but if you want to get clinicians on board with change, you have to seek input when designing processes and implementing systems, be transparent, and be patient — eventually they’ll see “the light at the end of the tunnel.” In this interview, Clement talks about how his relationship with Meditech has improved, the work his team is doing with analytics, and why some vendors just “get it.” He also discusses his career path, the most challenging — and rewarding — aspects of being a CIO, and why you’re only as good as the organization you work for.

Chapter 1

Chapter 2

  • Louisiana Health Care Quality Forum
  • Leveraging HIE “as a hub”
  • Why “some EMR vendors get it”
  • Benefiting from the ICD-10 delay
  • “You’re only as good as who you work for”
  • Recruiting from Nicholls State University
  • Making passion a core value

Read more or listen to the podcast at healthsystemCIO.com.

August 26, 2014, 4:05 pm

healthsystemCIO: Bernie Clement, CIO, Thibodaux Regional Medical Center, Chapter 1

Any CIO worth his or her salt knows the importance of getting physicians engaged; the big question is how to do it. In his three years at Thibodaux Regional, Bernie Clement has learned that there is no easy solution, but if you want to get clinicians on board with change, you have to seek input when designing processes and implementing systems, be transparent, and be patient — eventually they’ll see “the light at the end of the tunnel.” In this interview, Clement talks about how his relationship with Meditech has improved, the work his team is doing with analytics, and why some vendors just “get it.” He also discusses his career path, the most challenging — and rewarding — aspects of being a CIO, and why you’re only as good as the organization you work for.

Chapter 1

  • About Thibodaux Regional
  • Meditech in the hospital, eClinicalWorks in clinics
  • MU as “a key driver”
  • CPOE steering committee
  • Focus on physician engagement — “They want to understand why we’re changing something.”
  • Data analytics with Health Catalyst

Read more or listen to the podcast at healthsystemCIO.com.

August 26, 2014, 8:44 am

NPR Tip (MAGIC only) – Printing Radiology ($T RAD) Text and how to use ECB/ECE loop in a report

Joe Cocuzzo, Senior Vice President – Report Writing Services

In October 2002, we published a tip on how to print Radiology report text in an NPR report. At the time, there was no field or utility to do this (or possibly I just liked to do things the hard way), so our code showed how to open to the “saf” (sequential access file) or “raf” (random access file) containing the report text and send the text out to the printer or output file.

There is a utility program that will print the entire report body for you, and you can just put a program call in an LC or ECB and call this:

ECB=%RADRW.REPORT.print.report.lines(report),

Or for Addenda

ECB=%RADRW.ADDENDA.print.addendum.lines(addendum)

There can be a problem however, if you need to send the lines of text out with some data at the beginning of each line, or without the CR/LF at the end. It turns out if you pass a “B” argument to either of these utilities, they build the report text in /RPT.TEXT[report]T[n] = line of text and the addenda text in /ADD.TEXT[addendum]T[n] = line of addendum text.

So if we call %RADRW.REPORT.print.report.lines(report,1) the utility creates /RPT.TEXT[report]T[1] = first line of text
/RPT.TEXT[report]T[2] = second line of text

This month I will show you a report that selects reports and addenda for a signed date range, and then prints out the report and addenda text with some leading data (we will show line #) at the start of each line of text. We will use the two utilities to create the temp structures holding the report and addendum text and an ECB/ECE loop to print out the lines with a line counter at the beginning of each line.

The report example is a bit more complex because it also allows you to export a report if it was signed during the selected date range, or if one of its addenda was signed during the date range. This is useful for a billing service export because they typically want to get a report “again” if an addenda is attached and signed.

Step 1 is to build a report in RADRW.REPORT so it loops through the “radiology.report.exams” segment.  Note that we do not use an index.  Because we loop on the indexes in our own “start” macro (called at the beginning of the report) and make a list of the report urns in a slash structure, when we do an LI selection, the report goes directly to the list of reports we want and an index would only make the report slower (much slower).

NPR Image

Then on page two we prompt for a date range with an “IG” (ignore) operator and do an LI selection on /RPT.  That is a structure we will build in a “start” macro to make a list of all the reports signed in the date range and all the reports which had an addenda signed in the date range.

NPR Image

NPR Image

Next we call the two utilities in a “detail” macro (per each report and exam) to build /RPT.TEXT and /ADD.TEXT

NPR Image

Then in the picture, we “wrap a loop” around a line with an ECB and ECE and loop thru /RPT.TEXT, get the line of text out into the variable “DATA” and then put a line counter at the beginning of each line in five spaces left justified.

A computed field prints the line. We set TRUNC =NO so that even if the line exceeds the width we have defined, the entire value prints.

NPR Image

The output of the report is shown below:

NPR Image

A copy of the report RADRW.REPORT.zcus.is.report.addendum.export has been loaded to our MAGIC report library.

Visit our report library at http://www.iatric.com/Information/NPRReportLibrarySearch.aspx to look them up.

You can find additional Report Writing Tips on our website at http://www.iatric.com/Information/NPRTips.aspx, as well as information about our on-site Report Writer Training and Report Writing Services.

To subscribe for email notifications for new Report Writing classes, please follow this link:
http://www.iatric.com/Information/Classes.aspx.

For more information, please contact Karen Roemer at 978.805.3142 or email karen.roemer@iatric.com.

This article originally appeared in the August 2014 issue of Iatric Systems Updates! newsletter.

August 26, 2014, 8:41 am

SQL Tip – Parsing Patient and Provider Names

Thomas Harlan, Technical Team Lead – Data Repository at Iatric Systems

Tis but patient name tis my enemy;
Thou art five parts, though not in MEDITECH.
What is MEDITECH? It is nor first, nor last,
nor suffix, nor prefix, nor any other part
belonging to a name.
Oh! Be some other structure!
– Jules Capulet, Report Developer, Verona University Healthcare

If you are lucky enough to be up on MEDITECH 6, you can find the patient name broken out into discrete components in this table:

Livefdb.dbo.HimRec_Main

Where the HIM module has helpfully separated out NameLast, NameFirst, NameMiddle, NamePrefix and NameSuffix. But if you are dealing with a provider name – your stars are crossed there – or if you’re on MAGIC or Client/Server – you also have to break down the formatted string into its constituent parts.

In very general terms, that is:

LastName, FirstName MiddleInitial

If your site has been scrupulous about following the convention for patient names. For provider names, however, all bets are off… there are often suffixes or sets of suffixes; additional slashes or semi-colons and additional information at either the front of the provider name or at the end.

In SQL there is no built-in “piece of” function, as you would find in NPR with the # operator. If we want to break up a string into pieces, we need to use either an assortment of functions:

SELECT LEFT(ADV.[Name],CHARINDEX(‘,’,ADV.[Name])-1) AS LastName
RIGHT(ADV.Name,CHARINDEX(‘,’,REVERSE(ADV.Name))-1) AS FirstName
FROM Livendb.dbo.AdmVisits ADV

But this example is too simple… our FirstName field also includes the Middle Initial, if any. Or anything trailing the middle initial.

Or we use a custom function like IatricPiece() to pick out the parts of the string that we want:

SELECT  zcus.dbo.IatricPiece(‘,’,1,’BERMAN,JOEL F MD’) AS LastName
,zcus.dbo.IatricPiece(‘ ‘,1,zcus.dbo.IatricPiece(‘,’,2,’BERMAN,JOEL F MD’)) AS FirstName
,zcus.dbo.IatricPiece(‘ ‘,2,’BERMAN,JOEL F MD’) AS MiddleName ;

This gets us:

LastName

FirstName

MiddleName

BERMAN

JOEL

F

Which works perfectly for names in the standard format. You could also do the same with a more elaborate nested use of CHARINDEX. But creating the IatricPiece() function in your database gives you an endlessly useful tool with little or no overhead.

But what about those thrice-damned Montagues? I mean, provider names? Ones that have wound up looking like this (due to dictionary maintenance):

** DO NOT USE ** SMITH,JOHN P JR NP/JONES

When you see that, sir, I dare say you will bite your thumb, sir! At me, even.

(Note! If you are on MT6, check your DMisProvider table… you might have LastName, FirstName, MiddleInitial already broken out for you!)

To tackle this we need a function of more parts – and more sophistication than the simple IatricPiece(). We need Jim McGrath’s IatricParseProviderName() which breaks a more complicated string down into a one-row table containing the following fields:

full_name
last_name
middle_name
prefix
suffix
degree
mail_name
associated_doctor
other

Which looks like this:

SELECT * FROM zcus.dbo.IatricParseProviderName(‘** DO NOT USE ** SMITH,JOHN P JR NP/JONES’)

And produces:

full_name

last_name

first_name

middle_name

prefix

suffix

degree

mail_name

associated_doctor

other

SMITH,JOHN P JR NP/JONES

SMITH

JOHN

P

JR

JOHN P SMITH JR

JONES

The code for IatricParseProviderName() is attached to the tip for your edification, along with supporting code for IatricStripString() and IatricStripPuncuation() which help out along the way.

Once you have that in your zcus database, you can call the function via an OUTER APPLY (which acts like a SQL join, but is used to invoke a table-valued function once per row of your result set) and then use the name components in your SELECT field list:

SELECT DMP.ProviderID
,DMP.[Name]   AS ProviderName
,DMP.Active   AS ProviderActiveYN
,PPN.*
FROM Livendb.dbo.DMisProvider DMP
OUTER APPLY zcus.dbo.IatricParseProviderName(DMP.[Name]) AS PPN
;

But note that this only works if the code matches the name pattern in the dictionary…

(end)

EXEC zcus.dbo.MIS_zcus_iatric_find_query_config ‘CAN.OX’ — Query mnemonic to search for or ALL
,’ALL’ — Query text to search for or ALL
,’ALL’ — Document Section Mnemonic or ALL
,’ALL’ — Document Section text or ALL
,’ALL’ — Intervention Mnemonic or ALL
,’ALL’ — Intervention text to search for or ALL
,’N’ — Show Row Counts from storage locations

Visit our report library at http://www.iatric.com/Information/NPRReportLibrarySearch.aspx to look them up.

You can find additional Report Writing Tips on our website at http://www.iatric.com/Information/NPRTips.aspx, as well as information about our on-site Report Writer Training and Report Writing Services.

To subscribe for email notifications for new Report Writing classes, please follow this link:
http://www.iatric.com/Information/Classes.aspx.

For more information, please contact Karen Roemer at 978.805.3142 or email karen.roemer@iatric.com.

This article originally appeared in the August 2014 issue of Iatric Systems Updates! newsletter.

August 25, 2014, 3:24 pm

MUSE Webinar: Unplanned Downtime – It’s Not Going to Happen to Us, But it Did!

August 28, 2014 at 2pm Eastern
Cost: $100
Memorial Hospital in Belleville, Illinois, experienced an unplanned downtime that lasted 12 days. They had downtime plans that they thought would work but were not realistic for an extended downtime. Once the system was released they were back with an electronic EMR in both facilities within 39 hours. This webinar will share how they handled this experienced and how you can prepare should this every happen to you.

Presenter: Mary Lou Schmulbach

Organization: Memorial Hospital, Belleville, Illinois

Read more & register at MUSEweb.org.

August 25, 2014, 12:53 pm

HISTalk CMS Attestation Data

Jamie Stockton of Wells Fargo Securities provides updated slicing and dicing of CMS hospital attestation data through June 30. The significant Stage 1 vendors are (in order) Meditech, Epic, Cerner, CPSI, McKesson, and Medhost. Of the 10 hospitals that have attested for Stage 2, Cerner has four, Meditech and CPSI have two each, and Medhost and Allscripts have one each. Top vendors of the EHRs used by the 977 physicians who have attested for Stage 2 are, in order, athenahealth, Epic, and Practice Fusion, who have 97 percent of the Stage 2 attestations among them.

Read more at HISTalk.

August 22, 2014, 11:06 am

MEDITECH: Smooth Transition to 6.1 (Video)

Union Hospital of Cecil County CMO Cydney Teal, MD, describes her organization’s smooth 6.1 implementation.

Source.

August 21, 2014, 12:13 am

Clatterbridge signs up for Meditech

The Clatterbridge Cancer Centre NHS Foundation Trust has chosen Meditech for a new electronic patient record system, as it moves towards opening a new, £118m specialist cancer hospital in 2018.

The trust has signed a ten-year, £7.5m contract with supplier Centennial MIT to implement Version 6.0 of the Meditech EPR.

Clatterbridge signed a contract with IMS Maxims in 2002 outside of the National Programme for IT for a patient administration system, with Ascribe providing pharmacy and e-prescribing systems.

Thomas Poulter, the trust’s IM&T director, told EHI the trust ran an OJEU competitive dialogue procurement to find a new system and wanted to make sure the replacement at least matched the functionality of its existing software.

Read more.

August 21, 2014, 12:10 am

The CPOE Journey: From Inception to Implementation to Successful Early Adoption

The 2014 IEE Winning Session

Bonus! CEs for Nursing and Pharmacy

Henry Mayo Newhall Memorial Hospital (HMNMH) successfully implemented house-wide inpatient CPOE/Order Sets. In preparation for Go-Live, the interdisciplinary Order Set Team built over 190 evidenced based order sets, reconciled over 70 existing electronic order sets, and revised hundreds of electronic lab, diagnostic, nursing, and consult orders for ordering from a physician perspective.

Learn more or register for this August 26 MUSE Event.