As my hospital converts to more corporate applications, my Meditech system has become more interoperable. The folks at Meditech have been incredibly supportive of a very complex systems agenda at our site.
Revenue Cycle
A few weeks ago we went live with Siemens Soarian Financials and Scheduling, feeding our Meditech clinical systems. This two-year implementation was part of a corporate Soarian project and our hospital was the first site. The design is simple. Soarian Financials generates a “master” ADT feed to a “submerged” Meditech admissions module. Custom charge interfaces route from Meditech back to Soarian for billing purposes. Meditech has other submerged admission customers, but we’re told we are the first site using Soarian. Once Meditech receives demographic information from Soarian, the clinical dataflow remains the same.
This was an amazing effort by our local and corporate teams as well as our vendor partners — Meditech, Siemens and Accenture — who acted as the implementation consultants. This project, however, is only one example of how Meditech has helped make things work for me in my three year tenure as CIO of this site.
ERP
Because we are part of an integrated delivery system, our corporate direction has been towards more common systems, particularly in the fiscal and administrative spaces. For example, shortly after I arrived, we began a PeopleSoft implementation to replace Meditech’s HR, payroll, accounts payable, general ledger and materials management functions.
Ambulatory Interoperability and Medication Reconciliation
On the clinical side, our network has an internally developed integrated ambulatory medical record. Results and documents are sent from Meditech to be viewable in this EMR. We also have non-Meditech applications for the Emergency Department, Gastroenterology Unit and for medication reconciliation. In the latter case, we can pull medications from our enterprise medication repository to build a home medication list upon admission. For discharge, these meds can be reconciled with CPOE orders to create a new home med list. When the patient returns to their PCP, this medication list can be electronically reconciled in the enterprise ambulatory record.
Closed Loop Medication Administration
Our hospital implemented Meditech CPOE in the winter of 2006 to meet some quality metrics for our corporation. Meditech recommends installation of their eMAR product first, followed by CPOE. Because we had over 100 order sets in use and best practices, Meditech modified their eMAR module in ways we suggested. We delayed our eMAR project for the next release, but as a result, the CPOE, Pharmacy and eMAR functionality worked seamlessly.
Web Service Integration
Finally, the most challenging test of interoperability involves integrating Meditech allergies with our enterprise allergy repository (PEAR). In this model, an allergy recorded in Meditech is filed into PEAR, which can be viewed immediately in the native systems at other hospitals in our network, as well as our ambulatory record. Likewise, allergies filed in those systems are synched with the Meditech allergy record and displayed real time. This initiative is scheduled to be live early next year.
Not only has Meditech been patient with my significant changes, but also they have invested in making their system safely exchange critical data elements with other systems to support our evolving business model. Who says Meditech isn’t flexible?
Dale Sanders says
Very nice article, Scott…! A pragmatic and real life account that the vast majority of healthcare CIOs can relate to… Can you share a few more metrics about your IT staff and these projects? Number of staff, labor categories, costs, etc.?
Scott MacLean says
Thanks Dale – we are part of the Partners HealthCare System – I have about 30 local staff and purchase the services of about 12 more for core infrastructure and information security from Partners. For most of the projects I mention in the article, we also had a number of contractors and consultants to augment our staff since they are enterprise initiatives.
Jimmy Weeks says
Nice piece Scott,
As we both have seen, HIS\EMR is what you make it. Those who believe an application is limited to the functionality documented in a two hour sales presentation or within the pages of an end-user guide just don’t get it. I think some judge the capabilities of their HIS by the numbers of racks in their data center.
Since 1992 we have come to know the successes and extraordinary team efforts at Newton-Wellesley Hospital. It was a site visit to your location that launched our HIS 1.0 project all those years ago. Quite am impressive day with MDs complimenting the ease of use and quick response times. Yes, all that in 1992.
Keep pushing the envelope and sharing your successes. Further proof that if you can see it, it can be done.
Scott MacLean says
Thanks very much Jimmy – we sure appreciate the collaboration with you also and have learned much from our visits to Greenwich!