April 2018

Thoughts from Our President

As we have mentioned over the past couple of months, we are excited to have begun providing services to MEDITECH’s Canadian clients. We are currently engaged with two Canadian organizations with their MEDITECH Expanse (formerly known as 6.16) implementations.

As part of our commitment to establishing a strong presence in Canada, we will be attending the e-Health 2018 conference in Vancouver on May 27-30. We are excited to be presenting at the conference on Tuesday, May 29 and our topic, Aligning your EHR Implementation with HIMSS Stage 7, will be of great interest to many of you.

If you are planning to attend and would like to meet with us, please contact David LaFontaine, Senior Vice President, at dlafontaine@navinhaffty.com.

John Haffty, President

Navin, Haffty & Associates

Updates on MEDITECH’s Oncology

Many years ago, Navin, Haffty & Associates (NHA) was a strong advocate for an integrated EHR and encouraged hospitals to consider their core vendor’s Emergency Department (ED) application over a third-party product. At that time, while many of the niche vendor ED systems had more functionality and features than EHR vendor solutions, the value of integration to the enterprise usually outweighed those departmental advantages. Over time, the core EHR vendors, such as MEDITECH, added those features and now compare closely with ED system niche products. More importantly, as care coordination and communication has become more critical, the value of an integrated EHR has become more apparent. Towards this end, the entire industry, not just MEDITECH clients, are seeing adoption of the core vendor’s ED solution at a rapid rate, and abandonment of niche vendor products.

NHA has evaluated MEDITECH’s Oncology solution and we are seeing early signs of a similar trend. The coordination and complexity of managing care for oncology patients is challenging, and there has been significant movement in the direction of adoption of MEDITECH’s Oncology solution in the past year. At the end of 2017, 83 hospitals had licensed this product, with over 40 LIVE.

While there are many benefits of an integrated system for oncology care, the major advantages include:

• Single problem list
• Single medication list (which also supports reimbursement under the Medicare 340B program) and eMAR
• Single source for patient scheduling
• Single patient portal to improve access to data and patient empowerment
• Integration with the inpatient environment allowing seamless transition of orders

The top ten advantages of MEDITECH’s Oncology product:

• CMS quality reporting
• Cancer treatment detail available in the EHR
• Transition transfers to care settings
• Single patient portal account
• Comprehensive calendars
• Comprehensive order review process
• Enhanced patient safety with eMAR/bar coding
• Population health strategies supported through Patient Registries
• Single communication systems for enterprise
• Cost controls with drug banding features

While most of the product advancements are on the Expanse platform (formerly known as 6.16), we recommend checking with your MEDITECH representative on specific features/functions for other platforms. Lastly, we would like to point out the following enhancements are in the works:

• NCCN regimens – 100 regimens built; 40 regimens approved by NCCN
• Pre-populated standard content
• Designing Oncology to be web-based, under the Expanse platform

Note the MEDITECH product is focused on medical oncology but does provide interfaces to radiation oncology products.

IMO and NHA Team Up to Support IMO 2.0

The IMO 2.0 Enhanced Terminology Platform (ETP) is the critical component needed to realize the full power of clinical data. The power of structured data allows hospitals to provide measurable and actionable information to support quality improvement programs and highlights the financial benefits of achieving Meaningful Use (MU) Stage 3 electronic clinical quality measures. To fully appreciate the value and power of structured data, check out this article from the MEDITECH website.

There are many challenges and projects facing hospitals today, causing terminology updates to fall behind. IMO’s 2.0 ETP helps keep you current. It is important to note support for IMO 1.0 will end November 30, 2018.

NHA is proud to have been named IMO’s first certified MEDITECH partner to assist hospitals that may not have the resources to implement IMO 2.0 or support IMO updates in a timely fashion.

If you’d like more information on how IMO and NHA can help your hospital, contact IMO at sales@imo-online.com or NHA at info@navinhaffty.com.

Addressing New Criteria for MU Stage 3: CCD Changes in the HIE Criterion

In our February newsletter, we discussed implementing the three required measures under the MU Stage 3 Coordination of Care criteria. This month we look at what’s involved with implementing new required content in the Continuity of Care Document (CCD).

New Content Requirements for CCD

For Stage 3, the requirement to include the Care Plan field has been dropped. To offset this, Centers for Medicare & Medicaid Services (CMS) has added five fields. These include Unique Device Identifiers, Assessment, Health Concerns, Goals, and Plan of Treatment.

Unique Device Identifiers (UDI)

For the purpose of MU and creating the CCD, the Office of the National Coordinator for Health Information Technology (ONC) defines UDI as a device that is intended to be placed in a surgically or naturally formed cavity of the human body. A device is regarded as an implantable device only if it is intended to remain implanted continuously for a period of 30 days or more.

The UDI itself is composed of two parts: the Device Identifier (which specifies the type of device and its manufacturer), and the Production Identifier (specifying serial #, manufacture date, expiration date, lot number, and if applicable, identification codes for human tissue products [HCT/P]). Labeling of all medical devices with this information will eventually be required. The date by which labeling must occur is based on the class of device and its intended use. By October 2018, all Class II and III devices will need to be labeled, with Class I required by October 2020. The labeling must be in human and machine-readable form, e.g., barcode, and be published in the Global UDI Database (GUDID).

The GUDID is the FDA reference site for all implantable devices, and sites should establish an “always on” connection with the GUDID to obtain the latest UDI information on all implantable devices.

Implementation of tracking of UDI involves MEDITECH’s Surgical Services (SUR), Management Information Systems (MIS), and Materials Management (MM) modules. MM should contain a site’s complete inventory of implantable devices as the devices used during surgery are obtained from this MM database. The scope of this database can be sizeable; over the course of a year, one 300+ bed hospital utilized 1,900 separate items out of their inventory of 3,900.

There are two methods for documenting implanted or explanted devices. In SUR, a new surgical record is created, and the device is linked to the surgical procedure being performed. Information may be entered manually or by scanning UDI into the surgical record. Alternatively, users may document devices being implanted through the Patient Summary Screen in the EMR. Access may be established in the Person Profile.

Assessments, Health Concerns, Goals and Plan of Treatment

The remaining four new components to the CCD include:

1. Assessments—the provider/clinician’s diagnoses and conclusions that will dictate patient treatment
2. Health Concerns—the patient’s view of their health concerns documented at discharge
3. Goals—the provider/clinician’s judgment as to the level of achievable improvement if the Plan of Treatment is followed
4. Plan of Treatment—specific steps and actions patient is to follow

Each of these components can be documented within the Discharge Summary of MEDITECH Physician Care Manager (PCM). After entering the Discharge Summary screen, each of these four new components are available for free text entry (canned text may also be used). After each field is completed and the document is saved, all information will be included in the CCD. Documentation within MEDITECH Emergency Department Management (EDM) follows a similar process using the discharge/depart routine.

Depending on which version of MEDITECH you are running, there will be variations to the documentation process, and sites will need to determine the process that works best for their departments and facility. Education of providers will need to be planned and completed if compliance is to be achieved—these are new fields for providers to complete with the commensurate addition of time needed for documentation.

This is the third of a four-part series of articles covering MU Stage 3. If you missed the first two articles, click here to access “Meaningful Use Stage 3 Just Around the Corner” from the February newsletter and here to access “Challenges with Coordination of Care Criterion Under MU Stage 3” from March.

MU Stage 3 involves changes to all criteria and will require significant effort. For support with your preparation and planning, contact your NHA engagement executive, or email us at info@navinhaffty.com.

KLAS Update and Comments

NHA is very pleased to continue to be highly rated by KLAS. KLAS evaluates over 100 professional services companies and we remain one of the few that is consistently ranked in all categories where we provide services. As of April 2, we are proud to be in the top 10 in each of the four categories.

Below are some recent comments:

“With the help of Navin Haffty, we analyzed the reasons to switch to a different vendor and what it would mean for our organization. We did a lot of preplanning with them. We wanted to sell our board on the advantages of switching. We also wanted to be able to show how much cost would go into the transition. We are talking tens of millions of dollars and a lot of risk. Our position was to make the change, and Navin Haffty was instrumental in helping us work through that process, document it, and come up with estimates of costs and savings. Our board ultimately approved the switch.” – Executive

“Navin Haffty exceeded expectations in our engagement. They gave me all the details I needed and a budget that we are using right now.” – Executive

“Navin Haffty personalized the deliverables of the engagement to our organization. I could take the deliverables and copy and paste them right into the presentation that I gave. We had an amazing graphic of all these systems around different bolt-ons in the middle. We realized that, when we were done converting to our new system, at least half the bolt-ons were going to go away. We were going to have one system in the middle. When the board saw what everything looked like, they were shocked. That was probably a big selling point. And Navin Haffty put that graphic in there. The visualization helped.” – Executive

Please note selected commentaries may not represent the whole of provider sentiment related to this product or service. For a complete view, visit KLASresearch.com.

Quick Notes

• MEDITECH recently published a video in which providers discuss the benefits of partnering with MEDITECH. Of note, three of the four hospitals interviewed are NHA clients.
• Congratulations to MEDITECH’s AVP Cathy Turner who was recently appointed to a two-year term as co-chair of the HIMSS CNO-CNIO Vendor Roundtable, an advocacy platform for nurse executives that offers guidance on informatics competencies and other EHR related topics.
• HIStalk published a decidedly unscientific poll on which of the five largest EMR vendors made the best impression at the HIMSS18 conference. Of nearly 300 respondents, almost half rated MEDITECH as the vendor that made the best impression. This supports our observation of the excitement around Expanse.
  
• Congratulations to Phelps Memorial Health Center on the recent go-LIVE of MEDITECH 6.15 and Web Ambulatory. NHA is proud to have been the READY-certified consulting partner for this implementation.
• NHA is pleased to announce we have been selected by the following organizations for their upcoming projects:
  • Advocate BroMenn Medical Center, Normal, Illinois – PHA/RXM Support
  • Augusta Health, Fishersville, Virginia – PHA Optimization
  • Parrish Medical Center, Titusville, Florida – PCS Testing

   

NHA is Hiring

If you are interested in consulting, consider joining us. NHA continues to need excellent MEDITECH specialists and for the fourth year in a row, we have been named to the Top 100 “Best Places to Work” by Modern Healthcare magazine.

We are currently looking for those with MEDITECH 6.1 implementation experience, with a special interest in clinical leads, pharmacists, and specialists in the General Financials, HR/PP, AMB and RCG applications.

If you are interested, please contact us at recruiting@navinhaffty.com or call us at (855) 309-9334. See what positions are currently available by visiting the NHA Careers page.

Please note that at this time we are only able to consider those able to travel up to 80% of the time (also employees from MEDITECH and our clients cannot be considered).

Client Job Board

If you are interested in exploring new positions at other organizations, visit the client job board section of our website. This is a free service of NHA to the MEDITECH community. Currently, there are many postings from MEDITECH organizations. If you or a colleague are interested, check out what’s open.

If you would like to include your organization’s listing on the NHA website, please email Katie Kelly at kkelly@navinhaffty.com. Please note that as this is a courtesy to the MEDITECH community, we will not accept postings from recruiting companies.