January 2019

Thoughts From Our President

2019 marks the 50th anniversary of the founding of MEDITECH. As businesses come and go, there is much to be said for stability. MEDITECH has been at the intersection of software/technology and healthcare, two industries that have gone through more changes than virtually any other.

MEDITECH has begun to publicize this anniversary. The following statement from MEDITECH’s announcement expresses a sentiment I would like to share:

“Throughout our 25-year relationship, we’ve seen healthcare undergo massive shifts. MEDITECH has always found ways to evolve with us, support new strategic directions, and deliver results. As our two organizations have grown, the dedication to this partnership and achieving our common goals has only deepened. The foundation of such a relationship is trust.”

P. Martin Paslick
Senior Vice President and CIO, HCA

Congratulations to MEDITECH as they celebrate their 50th anniversary!

John Haffty, President
Navin, Haffty & Associates

William Greskovich Joins NHA as Vice President, Strategic Services

NHA is pleased to announce the hiring of William Greskovich who has joined our leadership team as Vice President of Strategic Services. William is recognized as a seasoned healthcare executive with more than 30 years of experience and extensive knowledge of hospital operations, process redesign, capital project management and information technology. His experience includes the development of long-range strategic plans and the management and implementation of clinical and information technology.

In this new role, William will be responsible for helping us to continue to expand and grow our strategic service offerings, including IT leadership, strategic planning, and advisory services, to better meet our clients’ needs. Prior to joining NHA, William served as Senior Vice President of Operations at Saint Agnes Healthcare, a member of Ascension Health. He joined Saint Agnes’ senior leadership team in 1997 as the organization’s CIO responsible for successfully implementing one of the first MEDITECH Client Server systems. Throughout his 20+ year tenure at Saint Agnes, William led all large capital projects, including the planning, financing/budgeting and delivery of Saint Agnes’ Campus Revitalization Project, resulting in the construction of a new bed tower, a new medical office building, and the modernization of all existing buildings and clinical technology with a budget of over $250 million.

William will lead our existing strategic services team which includes Scott Blanchette, Vice President, who has led our IT strategic planning engagements, numerous IT assessments and has developed our tools for determining total cost of ownership for Expanse implementations; Bill Winn, our Service Line Executive for Meaningful Use and Regulatory Services; and our team of CIOs who provide interim CIO services for many MEDITECH hospitals each year.

NHA’s strategic planning services have been recognized by KLAS over the years, including a Best in KLAS award and recognition as a top performer in the Meaningful Use planning and implementation study.

If you are interested in contacting William, he can be reached via email at wgreskovich@navinhaffty.com.

Many Smaller Providers Regret Switching EHRs

Over the years there has been much hype about the differences between the major EHR vendors’ products. We have been accused of bias when we report the results achieved between these three leading vendors are more similar than different. As noted recently in the KLAS Arch Collaborative project, physician satisfaction runs the gamut regardless of software and the outcome is more related to the implementation process and the training efforts than the software.

In December, Black Book Research published a study that found the majority of mid-sized hospitals regretted their decision to switch EHR vendors. It is clear to us they are referring to hospitals leaving MEDITECH (along with several other vendors) for Cerner or Epic. Here are key findings from this study:

“Modest-sized regional health systems expressed the biggest regrets, with 88% of respondents lamenting over a combination of vendor-hidden costs, unexpected consultant fees, interrupted revenue cycles, consumer frustration, time-extended rollouts, physician and clinical burnout, system downtime, reliability issues, and mismatches in vendor/client cultures when reviewing their vendor selection, whether original or replacement IT.”

According to Doug Brown, president of Black Book: “We found the majority (69%) of struggling hospital systems in 2018 that are dealing with very tight margins — or even losing money — regret their IT choices, which still have them teetering between being able to stay open or having to close.”

“… systems with less than 1,000 beds reflected on technological successes balanced with significantly higher-than-projected costs, related layoffs, declining inpatient revenues, unrecovered margins, increased IT salaries and wages, and disenfranchised clinicians.”

“…76% of community hospital C-suite respondents report they are continuing to doubt the benefits of switching EHR systems for brand recognition…”

“47% of all health systems in the red over their replacement EHR rollouts report the inability to achieve a true rebound in operating margin after four years post-implementation.”

“90% of hospital systems over 500 beds said they have been consistently over budget every year since EHR replacement rollout on projected EHR consultant costs, post-implementation EHR support, EHR-related staffing and now, EHR optimization initiatives.”

“71% of system users in 2018 responded that widespread interoperability and patient data exchange functionality actually declined after their replacement EHR rollout.”

“The automatic buy-in of physicians and other clinicians for certain replacement EHR brands was exaggerated.”

•  85% of responding executives admit the automatic clinical/physician buy-in they were oversold by vendors never materialized after a replacement launched.
•  91% of polled physicians question their vendors’ motives to insist on employing a consultant to evaluate their post-implementation product usability or training effectiveness.
• 72% of hospitals with replacement EHRs could not report any competitive advantages to attract doctors based on their new system.
• 84% of IT staff said they felt they had to coerce network physicians into adopting replacement EHRs via the hospital IT department.
• 98% of polled executives said physician and clinician EHR/IT-related burnout was never introduced by their vendor in the sale or implementation processes.

Hospital EHR replacements cost jobs, many left by choice:

• 64% of executive-level respondents stated they, or their peers, felt in employment jeopardy through the EHR replacement process.
• 5% of respondents at the manager level or higher claimed they or their peers were actually fired or asked to resign directly because of EHR replacement costs or productivity impacts.
• 22% said intermittent or permanent staff layoffs were directly caused by implementation delays, cost overruns, budgets underestimated, or unavailable trained personnel.

For those that have been following our newsletter over the years, we have made similar statements and raised questions on the hype regarding Epic and Cerner. Click here to see this study for yourself.

Canadian Corner

As we begin 2019, we want to share some thoughts for those of you considering implementing MEDITECH Expanse. In our observation, most Canadian hospitals have followed the traditional model of separating advanced clinical applications from the core implementation. As part of the READY model, MEDITECH has encouraged a “big bang” approach. The advantages to going “big bang” include:

• Taking advantage of all the functionality and efficiency designed into Expanse from the beginning
• As workflow process improvements represent a significant part of the value, planning the project to incorporate all functionality leads to a more optimal design process and better long-term results
• Focusing the entire organization on the project creates a sense of unity that often results in tangential communications and a re-examination of workflows
• The traditional two-phase approach creates a hybrid documentation model that is sub-optimal at best
• It is often difficult to fully re-energize an organization to take on the advanced clinicals in the second phase

While concerns about project resourcing exist, hospitals in the U.S. have learned to overcome this and discussions with those who reluctantly went down this path will overwhelming tell you they are glad they did so. If you are evaluating which path to follow, let us know and we can connect you with our many Expanse clients who have successfully followed this model.

In other news:

• The Canadian Forum at this year’s HIMSS conference will be held on Tuesday, February 12 from 10:30 am – 2:30 pm (EST) in room W315B. MEDITECH will be the sole sponsor of the HIMSS Canadian Forum. Join your peers at this event, which consists of three separate sessions sharing Canada’s digital health initiatives. MEDITECH will have several clinicians at their booth, #3921, including Parminder Ghuman, RN, Medical Informatics Liaison at Humber River Hospital, Toronto.
• Congratulations to Shared Health Information Network Exchange (SHINE) on the successful completion of their Expanse implementation. SHINE consists of three Ontario-based hospitals with a total bed count of 747: Southlake Regional Health Centre of Newmarket, Markham Stouffville Hospital of Markham, and Stevenson Memorial Hospital of Alliston. Markham was first to Go-LIVE, completing the migration from MEDITECH 6.0 to Expanse on September 1. Southlake and Stevenson completed their migrations from McKesson to Expanse on December 1, achieving the organization’s goal of all three sites being LIVE with one instance of MEDITECH.
• NHA is active at several Canadian hospitals, providing services ranging from Expanse implementation project management to report writing.

MIPS Requirements for 2019

The Centers for Medicare and Medicaid Services (CMS) released the final requirements for the 2019 MACRA (MIPS and APM programs) for clinics and individual providers. There are major changes to provider type participation, exemptions, penalties and incentives, scoring and weighting, and more. Click here to download the full MIPS article.

HIMSS 2019 Preview

The HIMSS19 conference is being held in Orlando from February 11-15 and once again, there will be plenty to see. Here are some key points:

MEDITECH will be at booth #3921.

MEDITECH will be sharing their strategic direction at three key sessions:

• Market Debut
  Tuesday, February 12 from 11:15-11:35 am (EST), Lobby F
  Stop by this session for a sneak peak of MEDITECH Expanse Population Health. See how this solution’s comprehensive care management and population analytics features empower care teams to manage patient populations across all settings.
• The State of A.I. in MEDITECH Expanse, featuring Nuance Communications
  Tuesday, February 12 from 3:15-4:30 pm (EST), Room 202A
  Learn how MEDITECH and Nuance are integrating voice commands into the Expanse EHR to streamline physician workflows.
  Click here to register
• Create, Share, and Grow with MEDITECH Greenfield, featuring Forward Advantage
  Wednesday, February 13 from 3:15-4:30 pm (EST), Room 202A
  Learn about Greenfield, MEDITECH’s new app development environment supported by RESTful APIs. Attend this interactive panel with MEDITECH’s API experts alongside early adopter Forward Advantage, to see how Greenfield will help cultivate user-friendly innovations in healthcare.
  Click here to register

MEDITECH will be conducting two special sessions:

• HIMSS Canadian Forum
  Tuesday, February 12 from 10:30 am – 2:30 pm (EST), Room W315B
  MEDITECH will be the sole sponsor of the HIMSS Canadian forum. Join your peers at this event, which consists of three separate sessions sharing Canada’s digital health initiatives.
• Leverage your EHR to Support Behavioral Health Interventions
  Tuesday, February 12 from 4-6 pm (EST), Location TBD
  Hear strategies from key industry thought leaders, exchange best practices, and build relationships during this exclusive event.
  CMIO Roundtable Discussion: 4-5 pm
  CMIO Networking Reception: 5-6 pm

MEDITECH will be conducting demonstrations of their latest products and solutions. Click here to sign up for your preferred timeslot for one of their demos:

• Expanse Population Health
• Care Across the Continuum
• Mobility with Expanse Point of Care
• A Healthy Bottom Line with Expanse Revenue Cycle
• Patient Consumerism

MEDITECH will be participating in the Interoperability Showcase throughout the conference at booth #9100.

Click here to see a list of education sessions being provided by a variety of MEDITECH clients.

MEDITECH will hold its annual customer appreciation event at Mango’s Tropical Café, Wednesday, February 13 from 7-10 pm (EST). Click here to register for this popular event. NHA is proud to be a sponsor of this event.

NHA will also have a strong presence at HIMSS19. If you are interested in meeting with one of our executives, contact David LaFontaine.

Quick Notes

• MEDITECH adds Diabetes Management Toolkit to MEDITECH Expanse Ambulatory.
• Congratulations to our friends at Memorial Hospital and Health Care Center of Jasper, Indiana on receiving the prestigious Malcolm Baldrige National Quality Award in Health Care.
• Our friends at MEDITECH have quietly run a Christmas giving program for many years. This year they put together a brief video of this project
• NHA is pleased to announce we have been selected by the following organizations for their upcoming projects:
  • Advocate BroMenn Medical Center, Normal, Illinois – MU DR Reporting Support
  • Harrington HealthCare System, Southbridge, Massachusetts – Oncology Build
  • Hi-Desert Medical Center, Joshua Tree, California – Proration Assistance
  • Hudson Regional Hospital, Secaucus, New Jersey – BAR NPR Support
  • Marshall Browning Hospital, Du Quoin, Illinois – Optimization
• Congratulations to two NHA clients on their recent Go-LIVEs:
  • Citizens Memorial Hospital, Bolivar, Missouri – migration from C/S to Expanse.
  • Steward Health Care (Central Region – various locations) – mixed platform migration to 6.15.

Client Testimonial

We are pleased to share a recent testimonial from one of our clients:

“NHA has always provided us with talented, professional consultants. They have played a critical role in many projects. NHA is our GO TO for our MEDITECH needs. We always look forward to working with them.”

Sherri Peral, Director of Information Services
Oak Valley Hospital District, Oakdale, California

Calendar of Events

New Doctors’ Hours Webinar – Winter Session

Root Cause Analysis: Improving Clinical Processes
Presented by Bryan Bagdasian, MD, MMM
March 4 @ 12:30 pm (EST)

NHA is Hiring

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

We are currently looking for those with MEDITECH Expanse/6.1 implementation experience, with a special interest in clinical leads/project managers, and specialists in the Ambulatory and Revenue Cycle Group (RCG) applications.

Additionally, we are looking for Canadians with MEDITECH implementation experience as clinical leads/project managers for Canadian based Expanse/6.1 projects.

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 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

NHA offers the client job board as a free service to the MEDITECH community.

Job Seekers: If you are interested in exploring positions at other organizations, visit the client job board section of our website often. Feel free to refer colleagues!

Recruiters: If you would like to include your organization’s listing on the client job board, please email the job description and candidate application instructions to Katie Kelly. No recruiting firms, please.