January 2015

• MEDITECH’s 6.1 became their most current version, extending the capabilities of advanced clinical applications with a total re-write of their Revenue Cycle and Surgical Services applications. Version 6.1 proved to be a stable platform and lays the foundation for significant new products.

• The Ambulatory product was delivered to five early adopter sites with a lot of excitement and high expectations.   

• According to multiple sources, this was the slowest year for new HCIS implementations in the industry. Most organizations appear to have picked their vendor partner. We expect this trend to continue for the most part in 2015.

• Meaningful Use continued to be the dominant priority for most hospitals.

• Many hospitals were well into their plan for ICD-10 when the delay was announced. While some continued this process, a number of others shut down their efforts.

• We expect the 6.1 migration momentum to become strong with demand building as the year progresses. Navin, Haffty & Associates (NHA) is aware of two major multi-facility health systems expected to commit to 6.1 in early 2015, adding more than forty hospitals. It appears a number of sites are waiting to see Ambulatory Go LIVE, but interest is high.

• MEDITECH has signed its first web-acute client and will begin the migration process in Q4 of 2015. Expect to see a lot more information on the web-acute version of 6.x later in 2015.

• With the transformation to web-based software for acute care, the delivery of the web-based Ambulatory product and 6.x versions of Home Care and LTC products, we believe MEDITECH is positioned to re-emerge as the leader in the industry. It will take successful implementations to build the confidence, but we believe that the level of excitement over its software suite will become noticeable by the later part of 2015. With all of this, we expect to see a return to growth in market share starting late in 2015.

• Based on the proposed scope of functionality in Population Health Manager, we expect this to be a big topic.

• MEDITECH has developed a new Critical Care Nursing application to be implemented at its first site in spring 2015. The following is from the MEDITECH website: “…At the heart of this solution is a Critical Care flowsheet, accessible directly from the Critical Care Desktop. The flowsheet supports both the documentation and viewing of all patient data in a single view, including immediate access to Medication Administration Record (MAR) and Transfusion Administration Record (TAR) documentation…”  This represents the most significant improvement for Nursing in many years with major improvements in both productivity as well as expansion of the full EMR.

• Unrelated to MEDITECH, we are seeing a steady improvement in the economy for much of the country. This is impacting hospital IT departments where tight budgets have limited salary increases and training budgets. This is resulting in retention challenges, particularly for technical staff whose skills are not industry specific. CIOs should be attentive to the risk of losing key staff.

• ICD-10 appears to be coming in October 2015 for real this time. If you deferred planning, preparing and/or testing, it’s time to re-engage.

• We believe the focus for many hospitals’ IT departments needs to be on optimizing what they currently have. In many engagements this past year we found under-utilized capabilities and sub-optimal workflows provided opportunities for IT to generate value without major capital expenditures. We believe the focus for most hospitals will be on transforming into more efficient organizations that deliver care under new financial models. The IT departments that lead those efforts will be recognized. While clinical redesign and transformation of the delivery of care (driven by Medicare Shared Savings and ACOs) will be a priority, areas such as supply chain management and revenue cycle are opportunities for pro-active IT departments.

• IT security will continue to grow in prominence as boards of directors and executives worry about exposure and negative publicity.

• Increase throughput and shortened average time from triage to departure.
• Decreased documentation time for both physicians and nurses.
• Reduced time spent preparing for weekend and holidays but using queries displayed on details section of the Status Board.
• Improved charge capture.
• For one site, eliminated third party billing software for physicians.

• Reduced quality monitor and turnaround times.
• By replacing a third party lab system, eliminated redundant charge/billing processes and redundant databases. Further, eliminated numerous interfaces realizing significant direct costs savings and efficiencies.
• Eliminated third party medical necessity product, realizing cost savings.
• Implemented numerous automated and paperless processes resulting in productivity gains and direct cost savings.
• Patient safety improvements, resulting in reduced errors, associated with positive patient ID and implementation of electronic transfusion administration record.

We hope these begin to demonstrate the value that READY delivers. We will provide more information in the next several months. If you have specific questions regarding areas of benefit, let us know.

• Meaningful Use Readiness Assessments – For both Stage 1 and Stage 2: While we expected hospitals seeking guidance on preparing for Stage 2, we were surprised by the number of hospitals that sought out our assistance with preparing for Stage 1. These were usually the result of organizations delaying a migration to another vendor, a delayed/cancelled acquisition by a larger health system or in one case, a re-evaluation of the impact of penalties to be incurred. We developed rapid remediation plans for each organization, determining the best approach to meet Stage 1 and positioning them for future MU stages.

• Clinical IT Strategy – For a MAGIC hospital with the stated goal of deferring a migration to 6.x for at least three years (as their capital budget is focused on other investments) while achieving the maximum value from MAGIC. We addressed governance and communication, IT staff development and training, reviewed/streamlining of work processes to take advantage of under-utilized MEDITECH capabilities, improved/increased interfaces to physician systems as well as other areas.

• Departure from a Hosted Solution/Collaborative – We were engaged by two small hospitals, each members of two different hosted solution, collaborative organizations. One hospital was seeking more independence from the collaborative while the other wanted to convert their clinical systems to another vendor as part of an affiliation while continuing to utilize their MEDITECH financial applications. NHA worked with both to identify all of the options available and to develop the best strategy for each.

• Third Party Product/Gap Analysis – Two organizations were preparing to migrate to 6.x and wanted a review of their current third party products to determine which to retain and which might be replaced by MEDITECH functionality in 6.x. Our assessment uncovered many products that could be sunset and replaced with 6.x, resulting in workflow improvements, eliminating interfaces and creating substantial savings. NHA worked with key users to identify how products were used and created business case assessments that allowed senior management to review and make informed decisions. In some situations, third party product functionality had been met or exceeded within current MEDITECH applications in 5.x and the migration away from these third party products and related savings were able to begin sooner.

• IT strategic plans including 6.x migration business case development

• ICD-10 readiness assessments and remediation plans

• IT staffing reviews

• 5.67 – MEDITECH’s Pathway to Meaningful Use in 2017

• Priority Event Opt Out Authority

• 5.66 Multidisciplinary Discharge Success Series

• 2014 AR Days Findings and 2015 Outreach Plans