Meditech 6.0 Diary: Part 1 — Culture Shock

Jorge Grillo, CIO, Canton-Potsdam Hospital

As some of you who have followed my past blogs know, I have just transitioned from a Siemens shop in Bermuda to a Meditech hospital in the great white north of upper New York State. Like most hospitals, we too have a strategy for meeting the regulatory requirements of Meaningful Use. For us, it revolves around moving from Meditech Magic to their new 6.0 platform. Since we will be one of the earlier hospitals migrated, I will attempt in the months to come to present a monthly blog of this journey, along with the road bumps, decision points, and other notable issues for those following in our footsteps.

The first thing to note is that we own and operate several provider-based practices, from family practitioners to specialty clinics like cardiology. Thus, we need to focus on an outpatient practice management system at the same time as we do the Meditech upgrades to capture the needed outpatient orders and EMR integration. For our environment, we partnered with eClinicalWorks (eCW) to achieve that goal.

The second point of noteworthiness is that since I have only very limited experience with Meditech, I had to get up to speed fast on both the Magic and 6.0 products and their differences. Also required was an understanding of how Meditech views and deals with the CIO relationship and the nuances of working with Meditech as a partner/vendor. CIOs new to Meditech who are requesting such education should not be surprised if it takes some time to arrange; the same with Webex sessions on specific modules or components of the application.

The interim CIO here lead the organization through the upgrade contract negotiations and a contract was in place upon my arrival. That meant my next step related to the actual upgrade was getting familiar with the project plan and deliverables. This was actually pretty painless, and included teleconferences with Meditech implementation personnel and internal staff brought me up to speed rather quickly, with only one major surprise — though the project had kicked off, the archiving component required some pre-clean up of dictionaries. This had to be performed by the analyst prior to any true migration work. Interestingly, Meditech did not assign a Project Manager (PM) to this phase, even though it required specialized training for the analysts.

Another interesting event was the ordering of hardware. For those unfamiliar with the Meditech model, that function goes through Perot Systems without the customer having an option on other hardware procurement models. Without getting into the plusses or minuses of that mandate, I will just say that it was a bit difficult to get the hardware ordered and shipped in the timeline required by the project plan. It seemed that the necessary coordination between all parties was lacking and again did not include a PM to help facilitate issues. In fact, the equipment was delivered to our shipping dock while we were on a call trying to procure its delivery.

The timeline itself is rather lengthy — about the same as doing a full reinstall of Siemens Medseries with full user training, namely over a year. The first year focuses on all the core Meditech modules, ER the following year, and a Phase 2 of CPOE and ER the year after that. Not having been to Meditech education and missed out on the sales components, I cannot yet expound on what is included or required in years 2 and 3.

The real work of the project is to start in November. That is when we actually get assigned a PM and meetings start in earnest, providing us with a more granular project plan and resource needs documentation. It is expected that user training and work will start in January, with a projected go-live the following October. With the kick-off still two months away, it allows us to focus on the eCW component of the project.

In the past 30 days since my arrival, there have been numerous meetings on defining the outpatient billing model we will use along with a master patient index. Both these components will need to integrate into Meditech, along with an exchange of clinical data from an EMR perspective. Luckily, the eCW technical support/interface person was very well versed in both those points of integration. After the model was defined and agreed to, he was able to quickly provide technical overlays and interface specifications.

The eCW timeline is based on a kick-off meeting last July, with the vendor teams scheduled to be on-site starting in October. It is estimated that we will go live on the first outpatient clinic starting in January, with others following every three weeks. As you can imagine, the drain on both technical support and analyst staff to do both these implementations — while still providing daily support — will be huge, and probably one of the biggest challenges to plan for and deal with.

I look forward to briefing you on the next steps of our Meditech 6.0 journey.

Part II