May 29, 2015, 11:44 am

Good Shepherd Community Hospital Gets On Board with Web Ambulatory

Good Shepherd Community Hospital (Hermiston, OR) is set to implement MEDITECH’s new 6.1 Web Ambulatory EHR. A MEDITECH customer for 15 years, the 25-bed Critical Access Hospital (CAH) has a proud history of providing quality care to its rural community.

With MEDITECH’s new Web Ambulatory product, physicians and clinicians will have a single clinical, billing, and sign-on solution to meet their evolving needs, so they can continue to deliver the best care possible to their community—right from any browser.

Learn more at meditech.com.

May 29, 2015, 11:38 am

healthsystemCIO.com: Ed Grogan, VP & CIO, Calvert Health System, Chapter 1

In the current health system landscape, where organizations just keep growing, Calvert Health System is considered to be quite small. But it’s a “mouse that roars,” according to CIO Ed Grogan, who has spent the past 12 years leading Calvert’s transformation from a small hospital to a dynamic health system. In this interview, he talks about the Maryland eCare initiative and partnerships that have expanded Calvert’s reach and helped improve care for patients across the state. He also discusses the organization’s comprehensive EHR-selection process—and why they ultimately chose Meditech; their work with CRISP, including plans to implement a “Magic button” for physicians; the importance of team chemistry; and his “passion for technology integration.”

Chapter 1

  • About Calvert
  • Allscripts ED, NextGen in ambulatory
  • 9-month EHR selection process: deep dives of “the big 3”
  • Meditech’s population health roadmap
  • Using consultants
  • 17 focus groups — “We wanted to engage all the major stakeholders in the organization.”
  • Physician advisory council

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

May 29, 2015, 11:33 am

healthsystemcCIO.com: David Baker, VP of IT, St. Joseph Health, Chapter 3

At St. Joseph Health, a primary focus across the organization is to give time back to clinicians by improving flow and ease of use. And to the IT department at the 16-hospital system, that has meant transforming the way they interact with care providers, and adopting the mantra of ‘people before tickets,’ according to David Baker. In this interview, he talks some of his team’s key initiatives, including efforts to standardize all of the hospitals to the same version of Meditech, create a platform to facilitate better communication among the staff, and move toward a virtualized environment. Baker also discusses the importance of leadership buy-in with any project, why it’s critical to push the boundaries, and the unique path that took him to his current role.

Chapter 1

Chapter 2

Chapter 3

  • Innovation Institute’s Shark Tank sessions
  • “Ever-maturing” security roadmap
  • Taking a page from finance
  • “Blend of responsibilities” as VP of IT
  • From “cutthroat” industries to healthcare — “I wasn’t sure what to expect”
  • Rounding & interacting with the staff
  • Building a diverse team

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

May 29, 2015, 8:44 am

MEDITECH’s MORE Events Bring All Platforms Together

Customers who attended our first two MEDITECH On the Road Events (MORE) — in Dallas and Myrtle Beach — agree we hit the mark with this brand new format.

Systems Analyst Karon Casey, of Granville Health System, noted, “I really liked the combined format of this year’s event. I enjoyed the breakout sessions and the customer panels, especially when physicians participated.”

Read more at meditech.com.

May 28, 2015, 12:57 pm

EHR vendor marketshare and MU attestations by vendor (chart)

The Centers for Medicare & Medicaid Services has paid out more than $30 billion in EHR incentive payments to hospitals and providers who have attested to meaningful use as of March 2015. Which platforms were used for attestation? We have some helpful charts that break it down for you.

According to CMS data, Epic Systems accounts for nearly 186,000 of those meaningful use attestations; Cerner is next up with 120,331 attestations, with Allscripts close behind at 99,091 to date.

Read more at healthcareitnews.

May 27, 2015, 11:58 am

Celebrating 25 Years: A brief video from CEO Joel Berman

Joel Berman - Celebrating 25 Years

Iatric Systems gives you three ways to celebrate with us at International MUSE 2015.

  1. Register to win TWO Apple Watches — one for you and one to share.
  2. Enjoy a piece of anniversary cake.
  3. Wear It and Win! Be seen wearing an Iatric Systems button for a chance to win gift cards.

Get ready to celebrate!

Discover proven solutions and services that help you successfully complete your projects:

  • Protect patient privacy
  • Connect your community
  • Enhance patients’ experience
  • Integrate your healthcare IT systems
  • Automate vital signs documentation
  • Reduce errors and adverse events

Our knowledgeable, experienced professional services team can step in and supplement your IT team on any project, large or small.

We look forward to seeing you at International MUSE 2015 Booth #810. Join the celebration!

May 27, 2015, 10:59 am

The 2015 Proposed NPRM: What is CMS Thinking?

by Kay Jackson, Education and Advisory Manager

As of last September, I’ve been watching for CMS to officially announce the switch to a shorter EHR reporting period for 2015. At that time, Congress first introduced Bill H.R. 270, designed to allow for a 90-day Meaningful Use reporting period, and the bill was supported by 33 co-sponsors.

Now, nearly eight months into reporting for 2015, CMS recently issued a notice of proposed rulemaking (NPRM), a complete game-changer for 2015. While this includes the reporting period change we were all hoping to see, I’m confused as to why CMS is changing the measures mid-reporting year.

We know that you have enough difficulties around Meaningful Use, so to have measures dropped mid-year has increased the stress and challenges. Of course, to add to the confusion, these are just proposed changes, and CMS must wait for comments before finalizing in August.

Adding to the confusion is the change for Core 6.2; dropping from a required >5% of patients accessing the portal to the requirement of only a single patient to access the portal. While this may seem like a relief, here’s the worry: for now, there’s a lack of focus on Patient Engagement; but then hospitals have to face Stage 3, where the proposed requirement for patients who access the portal jumps to greater than 25% of patients, along with the requirement to provide electronic access to educational resources to more than 35% of patients. An additional proposed change for 2015 is to remove the ability to include paper TOC for Core 12.1.

All of these changes seem to be Meaningful Use Madness, and leave me scratching my head. The Comment period ends June 15, 2015 so be sure to have your voice heard, and send your comments to CMS.

 

 

May 21, 2015, 5:43 pm

NPR Tip: “Echo Name” feature for Customer Report Screens (MAGIC Only)

Joe Cocuzzo, Senior Vice President – Report Writing Services

You may have noticed that MEDITECH standard NPR report screens can have “display only” fields, but in customer reports, there is no attribute or standard method to provide the same feature. In a CDS, you could just set the “Echo Name” flag to Y when building the screen.

This month we will show you how to add a “name echo” feature to a MAGIC NPR report. Our example will be a simple doctor dictionary report where we will show the name on the selection screen after a doctor is selected:

Instead of this:

NPR Tip Image

We want to have the selected doctor’s name display like this:

NPR Tip Image

Here is how to add a “display only” field to your MAGIC report:

Step 1

Add a computed field where the name will display, make it the appropriate length (for doctor name this is 30 characters) and use the “IG” (Ignore) selection operator.

NPR Tip Image

In Process Reports you have two options that allow you to modify the screen generated by the screen built automatically by the report translator. The “Edit Picture” option allows you to move or edit prompts, to add additional text, or to increase the number of entries that show for an LI or RL field. The “Edit Elements” option allows you to add or modify FCL, REQ, DFT, and IFE attributes for the screen fields.

NPR Tip Image

First we want to move the 2nd “xx.name” field to the right of the doctor mnemonic field, we can remove the “:” prompt entirely.

In the Edit Picture routine do this:

NPR Tip Image

NPR Tip Image

Then we use the Edit Elements routine to add an IFE=”” expression that shows the doctor name in 30 characters at the correct row and column and has the cursor skip the field.

The attributes that default for the “xx.name” field with the IG selection operator look like this:

NPR Tip Image

We need to make two changes. We need to change the REQ=1 to REQ=”” so the field is not required, and we need to add code to the IFE so that the field is skipped but the doctor name is displayed in the spot where me moved the field (to the right on the mnemonic).

It would be nice if the Report Screen program kept the row and column in some nice “R” and “C” variables for us to use in the IFE, but then we do not have that luxury.  We could hardcode values and experiment, but we’d need to adjust for the 3.x vs the 4.x workstation and code like this:

NPR Tip Image

This code uses the P() command to print the name in 30 characters truncated, left justified to row 0 (if 4.x Workstation) or 2 (if 3.x Workstation) and column 29.

Since you have a ruler line in the “Edit Screen” routine, it isn’t too difficult to figure out the row and column to use, you just need to check the @.gui flag to figure out if the screen starts on row 0 or row 2. 3.x screens use up two lines for the title and the horizontal line, and in the 4.0 workstation the title moves up to the Windows menu bar so your screen starts at line 0.

With this code, we have a report that works for both versions of the Workstation:

NPR Tip Image

NPR Tip Image

For extra credit, you could invert the name and display the doctor group mnemonic and name as well, like this: Try your own variation as appropriate to add relevant information to your NPR Report selection screens.

NPR Tip Image

NPR Tip Image

But what about C/S sites?

Unfortunately this trick won’t work in C/S because starting in version 5.6 all screen output is handled by a set of NPR.UI programs and calling them is blocked by the syntax checker. If MEDITECH added a DIS=N attribute feature to the C/S screen builder, you could do this the same way they do in Programmers NPR. Don’t hold your breath.

The MAGIC version of this report MIS.DOC.DICT.zcus.is.echo.name has been uploaded to our report library:

http://new.iatric.com/report-library-search

NPR Tip Image

You can find additional Report Writing Tips on our website at http://new.iatric.com/report-writing-tips, 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://new.iatric.com/schedule-of-classes.

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

This article originally appeared in the May 2015 issue of Iatric Systems Updates! newsletter.

 

May 21, 2015, 5:37 pm

DR+SQL Tip: Using UNION to Best Effect

by Thomas Harlan, Iatric Reporting Services Team

MEDITECH migrations platform bring many challenges; one of them being that you may find yourself with a new LIVExDB in the picture and once you’re past the go-live you find that data is flowing only into the new LIVExDB and not into the old one anymore.

This is particularly noticeable when you have a migration from (for example) MAGIC to MT 6.1. This gets you a database scenario like:

            livemdb                      (the old MAGIC environment data)
livefdb                        (data from the new MAT modules, post go-live)
livendb                       (data from the new C/S NPR modules, post go-live)

If you have DR-based reports in play already, when this change occurs (say on June 1st, 2015, as an example), then they are going to stop having new data in them on the magical migration day.

Then you need to update your reports – but how?

You could build completely new reports pointing at the new livefdb and livendb databases, but then your end-users will have to run two separate reports to get data about any patients admitted before the go-live and discharged after… and any kind of historical record-of-service reports will also have to be run separately.

Not so very convenient for your end-users!

SQL provides two solutions, however, and we will look at one of them here: using the UNION ALL keyword.

All In One

UNION ALL lets us run two (or more) separate queries against the DR server and combine the results; if and only if, the number of columns in the two queries matches and the datatypes of each column match. This lets us do something like:

— First from Magic

SELECT  MAV.UnitNumber
,MAV.VisitID
,MAV.AccountNumber
,COALESCE(MAV.ServiceDateTime,MAD.AdmitDateTime) AS ArrivalDateTime
,MAV.Status
FROM    livemdb.dbo.AdmVisits MAV

LEFT JOIN livemdb.dbo.AdmittingData MAD ON ( MAD.VisitID = MAV.VisitID AND MAD.SourceID = MAV.SourceID )

WHERE   COALESCE(MAV.ServiceDateTime,MAD.AdmitDateTime)
BETWEEN CONVERT(DATETIME,’2015-01-01 00:00:00′,120)
AND CONVERT(DATETIME,’2015-12-31′,120)
UNION ALL

— Then from C/S

SELECT  CAV.UnitNumber
,CAV.VisitID
,CAV.AccountNumber
,COALESCE(CAV.ServiceDateTime,CAD.AdmitDateTime) AS ArrivalDateTime
,CAV.Status
FROM    livendb.dbo.AdmVisits CAV

LEFT JOIN livendb.dbo.AdmittingData CAD ON ( CAD.VisitID = CAV.VisitID AND CAD.SourceID = CAV.SourceID )

WHERE   COALESCE(CAV.ServiceDateTime,CAD.AdmitDateTime)
BETWEEN CONVERT(DATETIME,’2015-01-01 00:00:00′,120)
AND CONVERT(DATETIME,’2015-12-31′,120)

When we launch this query the SQL engine splits the work into two parallel queries and executes them simultaneously. So performance can be quite good. MEDITECH’s data structure is challenging to speed, however, because we have to look at two (or more) different fields in different tables to get the ArrivalDateTime.

However, this will get us visits on either side of the gap at go-live and since the fields line up in number and type, the report we build on top of this won’t know the difference. And neither will the user!

Dangers of Union

One gotcha to watch out for with UNION, however, is that since each section runs in parallel with one another; if each part is hitting the same tables in the same database, sometimes they block each other – and then performance falls off a cliff while each waits for the other to release database page locks. And this is bad.

So our rule of thumb is to avoid using UNION with queries accessing the same tables in the same database. In our example, we don’t have this issue – the table names may be the same, but they are in entirely different databases.

In the version of UNION that we’ve looked at so far, we have the “ALL” keyword added – this just combines the results of the two queries into a single result-set.

Union to Unique

But there is also just plain old UNION, which compares the two result-sets and discards any duplicates, producing a single set of unique rows. That is sometimes useful, but that requires more overhead to compare two sets and produce a third to return to you.

Alternatives

If you find that you need to run two or more sets of queries against the same sets of tables and combine the results; you don’t want a UNION at all. That will get you the performance issues we’ve just mentioned. In this scenario you:

  1. Create a temp table with a common structure.
  2. Run each query in sequence, INSERT-ing the results into the temp table.
  3. Return the whole contents of the temp table to your report or extract.

(end)

Visit our report library at http://www.iatric.com/Information/NPRReportLibrarySearch.aspx.

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 May 2015 issue of Iatric Systems Updates! newsletter.

 

May 21, 2015, 11:34 am

“Interoperability: The Difference for Patients”

ExecutiveInsight recently published a new article, “Interoperability: The Difference for Patients,” that explains how interoperability can make a difference for patients and save hospitals time and resources.

Read this article to learn how interoperability allowed St. Luke’s Hospital to speed the determination of disability for patients. The unique requirements for data transfer, and the implementation of custom interfaces, allowed St. Luke’s to save hundreds of hours of staff time, which equated to annual savings of more than $10,000.

The greatest benefit was reducing disability determinations for patients from 6 months to only weeks. This is an excellent example of how interoperability can really benefit patients.

Read the article here.