September 30, 2014, 12:35 pm

HISTalk: MEDITECH 2013 Annual Report

Meditech finally issues its 2013 annual report that was due 11 months ago but was held up following revenue recognition changes. Revenue was down a bit from 2012 at $580 million, but net income rose to $133 million (that’s an enviable margin). Neil Pappalardo owns nearly 41 percent of the company, or about $680 million worth. The directors and officers of the company have been around forever, with the newest hires among their ranks having joined the company 24 years ago.

Read more at HISTalk.com or comment here.

September 29, 2014, 12:31 pm

MEDITECH: Lucky Stage 7

Two customer executives share their organizations’ success after reaching HIMSS Analytics Stage 7.

Source.

September 29, 2014, 12:28 pm

MEDITECH’s 6.x READY Customer McLaren Port Huron Hospital Goes LIVE

When the time came for McLaren Port Huron Hospital (Port Huron, MI) to replace its EHR, CIO Mark Richard knew what he wanted — reliable, quick-to-implement software that would help the 186-bed hospital reach Meaningful Use.

“Some organizations like to build and convert one department at a time. Not us — I asked for an organization-wide, standard content implementation and big-bang go-LIVE,” he says. “I’ve been involved in many large-scale implementations, and this is the first one that turned out as promised.”

Read more at meditech.com.

September 24, 2014, 12:38 pm

Philips IBE and PIIC iX: Understanding new integration options

Join us 9/30 at 2PM ET for a webcast on Philips IBE and PIIC iX: Understanding new integration options

We know there’s a lot to consider when purchasing or upgrading Philips equipment — patient care needs, cost of the equipment, how to integrate the devices with your EHR, and more. In 30 minutes, we can explain — in easy to understand terms — your options for integrating Philips equipment with your EHR.

Casey Chester, Lead Developer, has more than a decade of IT experience, the last six years of which have been spent focused on medical device integration, specifically Philips device integration. Come to this 30-minute Powercast presentation to learn:

– Your options for passing demographic data from your EHR into your Philips monitoring equipment
– Your options for passing clinical results from Philips monitoring equipment back to your EHR

Learn more or register.

September 22, 2014, 12:36 pm

SQL Tip — Making Your Own Legos

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

Today we play with Lego, or rather we make our own Lego. No, not this way, but in SQL. One of the tremendous things about SQL and the Data Repository is that you can roll your own building blocks and use them over and over again, easily, saving yourself a lot of work down the road — and also making your reports more consistent.

Our goal is to make a SQL function that returns a “stacked” data item — one that reflects the hierarchy of the patient’s progress through the facility, to discharge, and then abstracting. In this case we’re looking at the Primary Diagnosis of the visit.

Simply put, what we know about the patient primary diagnosis (or complaint) advances through the following progression:

Visit Stage

Data Item

DR Field

Quality

ER Presentation

Complaint

EdmAcct_Main.StatedComplaint

Poor

Admitted

Reason for Visit

AdmVisits.ReasonForVisit

Better

Initial Abstraction

Reason for Visit

AbstractData.ReasonForVisit

Good

Final Coding

Primary Diagnosis

AbsDrgDiagnoses.DiagnosisName

Best

Our little chart makes it clear our understanding of the patient changes over time, and is refined as they progress through the care cycle. On our reports, we want to reflect that, and reflect it easily, in a consistent way.

Thus, a custom function! We’ll call it IatricPrimaryAdmitDiagnosis (which you will find attached to this tip). We call it from a query showing patient visits where we have access to the SourceID and VisitID fields, like so:

SELECT  ADV.SourceID
,ADV.VisitID
,ADV.ServiceDateTime
,AdmitDX = zcus.dbo.IatricPrimaryAdmitDiagnosis( ADV.SourceID,ADV.VisitID )
FROM    Livendb.dbo.AdmVisits ADV
WHERE   ADV.ServiceDateTime BETWEEN GETDATE()-30 AND GETDATE()
;

Executing that code gets us a wide variety of results… let’s look at the ones from today:

2014-09-05 21:33:00

TOOTH PAIN

2014-09-05 21:35:00

APNEA

2014-09-05 21:40:00

COUGH,RUNNY NOSE

2014-09-05 21:45:00

EXTREMITY PROBLEM

Some of these patients are in the ED right now – and no one has had a chance to do more than capture the patient’s impression of their issue. If we’re lucky, a triage nurse is taking down this documentation. Now if we look at the visits from 30 days back — patients who have likely been discharged, abstracted, and final coded:

2014-08-06 22:51:00

FX DISTAL RADIUS NEC-CL [813.42]

2014-08-06 23:36:00

TOXIC EFFECT VENOM [989.5]

2014-08-07 00:46:00

ACUTE CHOLECYSTITIS

2014-08-07 03:31:00

FX FEMUR, MIDCERVIC-CLOS [820.02]

Now we have something more solid! Real ICD-9 diagnosis codes and names. Except for one poor soul who is still an Inpatient… When you review the code for the function, you’ll see it uses a COALESCE() (a standard SQL function that returns the first non-NULL value it finds in the list of parameters) to represent this hierarchy:

COALESCE( ADX.DiagnosisName+’ ['+ADX.Diagnosis+']‘ — Final Coded diagnosis #1
,ASD.ReasonForVisit  — Abstracted Reason for visit
,ADV.ReasonForVisit  — ADM.PAT.reason.for.visit (cleaned up from EDM complaint)
,EAM.StatedComplaint  — EDM Stated Complaint (pretty rough)
) AS AdmitDiagnosis

In this structure, we’ll get back the abstracted diagnosis first (if it exists), then the abstracted reason for visit (often filled in while the patient is still in-house), then the admitting reason for visit and finally the ED stated complaint if nothing else exists.

Warning!

This is a super-useful function for displaying reason for visit, on a report. But you should NOT try and use it as part of a WHERE clause to look for kinds of reasons of visit, or for primary diagnoses. Performance, in that scenario, will be quite poor.

Extra Credit

There are other data fields which might, depending on how your enterprise handles pre-abstracting documentation, have the admitting diagnosis as well:

AdmittingData.AdmitDiagnosis
AdmittingData.MedNecDiagnosis
AdmDischarge.ErDiagnosis

If these fields are populated in your MT environment – add them to your copy of the function!

(end)

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 September 2014 issue of Iatric Systems Updates! newsletter.

September 22, 2014, 12:33 pm

Writing files from NPR report to a shared folder from a scheduled or submerged report (MAGIC Only)

Joe Cocuzzo, Senior Vice President – Report Writing Services

The only “officially supported” mechanism to write a file to a non-MEDITECH machine is to use FTP. This means you need to set up an FTP as a service on the destination machine, which typically involves installing additional software.

It would be much more convenient if you could write files to any Windows PC in the network using a regular windows user ID and password.

It turns out you can. Microsoft has a protocol called “Server Message Block” that allows you to read and write files, created folders, and read directories and MEDITECH has a set of Z programs and OS utilities that support this protocol.

This month I will show you how to use Z.smb.put.raf to write a file from an NPR report to a share using a regular windows user ID and password.

First we need to have a place to keep our Windows user ID and password information.  The FTP remote host dictionary is a good place, and at most sites this will hide the password information a bit better than just putting it into our NPR report source code.

NPR Tip

Next, we write an NPR report where we do all output in a macro, which builds lines of data in a memory based RAF. This is similar to the way you can build a MOX message in a temporary RAF and then use MIS.OA.MSG.auto to send a MOX message.

Set up Page 1 as you would a report with no picture and put a program call to a macro in the title:

NPR Tip

The program call in the title is so you can set a flag to suppress the PRINT ON prompt and any report messages. The code in the “setup” macro looks like this:

NPR Tip

(It probably would be okay to set the /Z.SCHED.LOG and /R.NO.RPT.MSGS flag multiple times, but just in case we set the report up to just do it 1x. The title program is executed when the report first displays a selection screen and then as it prints each new page.)

The report has NO PICTURE, just a footnote to call a macro (“detail”) for each record. Our demo report just has one selection, where you identify the MIS.FTP remote host where the password and host information is kept:

NPR Tip

NPR Tip

 

In the “detail” macro we send data to a random access structure in memory:

/STUFF[n] = data (including CR/LF)

Note that this technique of writing the data to slash (memory based temp file) should not be used for extremely large records. In our case, each file is only two lines long. If you need to send very large files this way, you would write to an RAF as a disk file in your own directory.

The arguments to the Z.smb.put.raf program are:
A = HOST (ip or server name of the host to send to)
B = USER (windows user id of user with rights to the share)
C = PW (windows password of user in argument B)
D = Share name
E = Path and file name
F = “name of” the raf structure with the data to put in the file
(^/STUFF^F would put the “name of” the RAF into F)

Here is the “detail” macro showing how the lines of data are put into /STUFF[line number] and how the file is transferred to the shared folder.

NPR Tip

IMPORTANT NOTE: Make sure you enable the SHARE for your user on the server. Otherwise you will get an error when MEDITECH attempts to write the file to the share.

The report makes files very fast, far faster than FTP, especially if you have a lot of small files to create:

NPR Tip

A sample MAGIC report has been uploaded to our report library ADM.PAT.zcus.is.smb.transfer

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 September 2014 issue of Iatric Systems Updates! newsletter.

September 19, 2014, 1:40 pm

MUSE Community Peer Group Chicago

Join Iatric Systems – we’ll be at the October 2 MUSE Community Peer Group Chicago at Swedish Covenant Hospital, 5145 N. California Ave, Chicago, Illinois.

Looking for help with CCD and Direct Messaging? Partner with your peers to create solutions and grow together. Learn from each other’s successes and experiences. There is value in networking and value in identifying local experts.

New topic added:  Patient Portals. Join the discussions!

Register for the Chicago Community Peer Group and join your MEDITECH colleagues at this program, designed to provide you with new contacts, rich resources and valuable take-homes!

The event will include plenty of collaboration and networking time, plus presentations and discussions. Lunch is also included!

Learn more.

September 18, 2014, 12:31 pm

healthsystemCIO.com: Michael Martz, CIO, Meadville Medical Center, Chapter 3

Sometimes the smallest detail can result in major downtime. It was a lesson Michael Martz learned nine months into his tenure as CIO at Meadville, and one his team will never make again. Because as frustrating as it was when the hospital lost its main data center because of a battery that failed during a generator test, the experience strengthened the organization’s disaster preparation strategy. It’s that philosophy of always learning that has helped Martz lead the organization through major changes during the past three years. In this interview, he talks about being an early adopter of Meditech 6.1 and a beta site for the a new web-based ambulatory product, why he opted to use consultants , what it’s like being a standalone in a large IDN world, and his honest take on Meaningful Use.

Chapter 1

Chapter 2

Chapter 3

  • From Seattle to PA
  • First healthcare CIO role — “I’m constantly on a learning curve”
  • Meadville’s “strong focus on virtualization”
  • Downtime for “the most absurd reason”
  • His leadership philosophy — “It’s figuring out how to serve them.”
  • Being beta tester #1

Read more at healthsystemCIO.com.

September 15, 2014, 1:57 pm

MUSE Webinar: Clinical IT Leadership and Governance

September 24, 2014 at 2pm Eastern
Cost: $100

In order to make the best possible decisions, healthcare organizations need the involvement of healthcare clinicians. Over the course of the last two years SwedishAmerican Hospital has created a leadership and governance structure whose two goals are:

1. Decisions regarding clinical IT will be based upon the needs and opinions of the clinical users.

2. The process by which those decisions are made will be standardized, transparent and responsive.

This webinar will discuss the challenges and opportunities of developing a formal change governance structure, EHR change request process, workgroup formation, and committee structure.

Learn more at museweb.org.

September 15, 2014, 12:43 pm

5 Ways to Keep Your Interface Projects Under Control

Interface projects can be challenging and they are often the tasks that take longer than planned or go over budget. Yet interfaces are critical to your hospital’s efficiency and the quality of patient care.

Hear how we can help you get control of your interface projects. Register for this webcast now and find out how you can get your interface projects completed on time and on budget.

Learn how we can help you:

  • Get interfaces built efficiently
  • Deploy higher quality interfaces
  • Increase staff productivity

Register for this Webcast: September 23, 2014, 2:00 p.m. ET presented by Rich Murphy, Vice President of Interface Software at Iatric Systems, Inc.