May 2020

Thoughts From Our President

As reported in HIStalk, KLAS announced MEDITECH experienced significant gains in its share of the U.S. EHR market in 2019! As shown in the table below, KLAS measured wins and losses in terms of inpatient beds. While this would favor vendors with a greater presence in large academic medical centers (as they have many more beds than community hospitals), MEDITECH emerged a strong second to Epic. From HIStalk 5/1/20:

“A new KLAS report on US hospital EHR market share finds that Meditech Expanse is drawing new interest from customers outside its usual small-hospital base, with a new 400+ bed health system sale in 2019 giving the market a chance to see how Expanse scales. Meditech won about half the decisions made by its legacy customers in 2019, and half of its losses came from product standardization and provider M&A…”

We have stated for many years there are only three strong EHR vendors in the market: MEDITECH, Epic and Cerner. However, if you look closely at the table above, MEDITECH gained more than 5,400 beds in 2019, almost 2,000 more than Cerner. Most significant are Cerner’s losses, which are greater than all other vendors combined. We believe this shift is more than a coincidence and is evidence of MEDITECH’s Expanse platform being rapidly adopted by the market.

John Haffty, President
Navin, Haffty & Associates

COVID-19 Readership Survey

As a valued member of the MEDITECH communtiy, we are intereseted in knowing how COVID-19 is affecting you and your organization. Please complete our 5-question survey; results will be published in our June newsletter.

NHA Technical Services Highly Ranked in KLAS

HIStalk recently shared the news of NHA being among the top-rated performers in KLAS’ April 2020 performance report: “Technical Services 2020: A Tip-of-the-Spear Look at a Growing Market.”

We are proud to announce we ranked as the top MEDITECH consulting firm for client satisfaction, offering the best balance of price and performance. To our many clients, thank you for continuing to provide high praise to KLAS. In 2019, NHA was awarded Best in KLAS for Technical Services.

Visit our website’s Analytics, Data and Reporting page for more information on our technical services, or contact us at info@navinhaffty.com. If you are a KLAS subscriber, view or download the report here.

NHA’s Virtual MEDITECH Support

NHA is here to support you and your MEDITECH system through these uncertain times. We are all experiencing disruption to our normal business operations and our staff’s availability. If any of your team is sidelined, such as for redeployment to alternate duties, quarantine, or childcare issues, NHA is prepared to provide as much or as little support as you need on a remote basis.

All of our MEDITECH services, such as implementation, application support, staff augmentation, report writing, can be performed remotely. We continue to be the MEDITECH partner you can depend on. We have prepared our consultants with the processes and technology required to help you keep the lights on through these times.

Contact us at info@navinhaffty.com or 781-871-6770.

Congratulations to MEDITECH’s Carol Labadini

MEDITECH’s Carol Labadini has been promoted to Vice President overseeing MEDITECH’s Implementation Division.

Most recently serving as Associate Vice President of Client Services, Carol has been with MEDITECH for over 28 years. She began as a specialist in the Client Services group supporting physician and nursing products and has since held a variety of roles. She was instrumental in incorporating company-wide best practices across every department while leading implementation efforts for the new web-based Ambulatory EHR.

Carol is a graduate of Northeastern University and has had a passion for healthcare from an early age. Prior to MEDITECH she worked at Massachusetts General Hospital and in a private physician practice where she developed an interest in leveraging technology to improve care and communication in healthcare.

Canadian Corner

Queensway Advances its Use of MEDITECH for COVID Clinic

Regionally tasked with setting up a COVID-19 care clinic, Queensway Carleton Hospital and Tim Pemberton (Vice President, Information Management, Clinical Support, CIO and CPO) set out on a journey to transform a vacant school building in the west end of Ottawa. The clinic would treat residents with mild to moderate symptoms to circumvent their presence in the hospital setting. The clinic was built from scratch over a short two-week time period.

With EHR technology initially ruled out for the clinic, physicians would be faced with the difficulty and challenges of documenting on paper. Though more complex, Dr. Joseph Pollard and other front-line physicians pushed for the use of computerized physician order entry (CPOE), a technology being implemented, but not yet LIVE, at Queensway (and the larger CHAMP collaborative of six Ontario-based hospitals). Armed with a vision, Tim quickly pivoted to determine the best way to leverage the existing groundwork built by the CHAMP Advanced Clinical Systems (ACS) team, NHA and MEDITECH. According to Tim, “Dr. Pollard wanted CPOE, and quickly. It was a gutsy decision in middle of pandemic, but he saw the value in it. By the first week in April, we went LIVE, very successfully, without major issues.”

Queensway’s ACS IT team, led by Rico Audet, leveraged the foundation of the CHAMP CPOE build and utilized MEDITECH’s Emergency Department Management (EDM) solution for its triage and tracker functionality. Rico and team created the COVID protocol order set, documentation and scheduling templates. Despite the complexity and workflow shifts, the team embraced the pilot unit and brought LIVE the new functionality within a week. After an expedited round of training and Go-LIVE support, Queensway clinicians began reaping the benefits of electronic orders and protocols, providing standardized care to area COVID patients.

Tim has begun preparing for the new normal and potential wave 2 of the COVID response. “How we were planning to Go-LIVE with CPOE in the hospital setting isn’t going to apply anymore,” he projects. Patient registration, socially distant waiting rooms, and a shift in how clinicians are trained may dramatically change. Tim’s future plans include moving forward with MEDITECH’s Virtual Visits and patient portal solutions. He adds, “Now that the physicians have seen MEDITECH in action, and its value, they are anxious to bring it LIVE in the hospital setting.”

Explore the Benefits of Cloud-Based Solutions for Your MEDITECH EHR

We have all experienced a transformation in the way we interact with technology over the last two months. We’ve learned to embrace Zoom meetings, remote learning, as well as virtual visits with our healthcare providers.

The universal shift to subscription-based services delivered via the cloud is accelerating globally, and this includes electronic health records. Statistics show that worldwide, the healthcare cloud market was over $23 billion in 2019, with the highest adoption rate in North America, where 40% growth is expected over the next five years.* This transformation is forcing a shift from IT as a capital budget expenditure to a monthly operational fee, which, although not in line with traditional governmental funding, may offer substantial benefits, flexibility, and cost savings.

Cloud services for healthcare take many forms, and incorporating cloud service elements into your overall plan is far from an “all or nothing” decision. There are different types of clouds (public, private, and edge), and different types of services (Infrastructure as a Service, Platform as a Service, and Software as a Service). Cloud-based solutions can range from full hosting, to point solutions such as disaster recovery, backup as a service, archiving, and remote systems management. Each comes with a variety of service levels, management, and costs. Exploring the options has become a key component of developing an overall IT strategy. MEDITECH supports public and private cloud options and continues to invest and innovate with their cloud partners.

NHA, CloudWave and MEDITECH have been working together to help hospitals in Canada leverage the cloud in ways that make the most sense for each unique organization or network. With enhanced security, cost efficiency, reliability, and improved accessibility at the heart of each decision, we have successfully helped hospitals realize the benefits of cloud while focusing their IT teams on providing value to end users.

Interested in learning more? Contact Erin Mueller to schedule your complimentary cloud transformation workshop.

* “Healthcare Cloud Computing Market by Product,” MarketsandMarkets

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Important Regulatory Updates Due to COVID-19

We are all aware of the four relief acts passed by the federal government, but various other federal agencies have made modifications to their programs’ deadlines and requirements. The list below is not exhaustive, and like other dynamic situations, the items noted are subject to change.

Recent Federal Actions

• Hospitals will be able to add more beds without a cut in Medicare payments
• Long-term care hospitals (LTCHs) will be paid at a higher rate when accepting patients from acute care hospitals
• Hospital outpatient departments may relocate off-site and still be paid under the Outpatient Prospective Payment System (OPPS). Locations could include parking lots, patients’ home, or temporary hospital locations
• Emergency Medical Treatment and Active Labor Act (EMTALA) requirements have been clarified regarding a site’s capability to provide isolation and treatment, or if a transfer is justified
• Telehealth
  • Outpatient departments can bill for certain Medicare telehealth services
  • Additional provider specialties may bill for telehealth services, e.g., PT, OT, speech pathologists
  • Reimbursements for audio-only visits have increased, with payments ranging from $46 to $110/visit
  • Physicians will be reimbursed for virtual visits at the same rate as in-person visits
  • Telehealth may be used to fulfill face-to-face requirements for rehab, hospice and home health, and to provide remote patient monitoring services
• CMS originally accelerated the following Medicare payments (independent of the CARES Act), but some modifications are being made:
  • Expedited/advance payments under the Accelerated Payment Programs are being reevaluated with a look to decreasing
  • Payments under the Advance Payment Program have been suspended
  • CMS is looking to replace these loans with direct payments from the remaining funds available from the $50 billion allocated to hospitals in the CARES Act
• Additional CMS changes:
  • Healthcare professionals ordering COVID-19 tests will be reimbursed (if authorized by state law)
  • Evaluation and Management (E/M) may be delivered to patients via telephone
  • Hospitals may bill Medicare if hospital-based providers deliver remote services
  • Telephone-based behavioral health services will be reimbursed at the same rate as office visits
• As of the end of April, some of the remaining Provider Relief Fund money is being distributed based on 2018 net patient revenue data found in CMS cost reports. If your site does not have current cost report data on file, revenue information can be submitted here
• For accountable care organizations (ACOs):
  • Increased COVID costs will be considered to assure no penalty will be assessed
  • No application cycle for 2021 (allowing ACOs to maintain 2020 risk levels in 2021)
  • New ACO applications won’t be accepted until 2021
• For home health patients, nurse practitioners (NPs), physician assistants (PAs) and certified nurse specialists (CNSs) may order services, develop plans of care, and certify/decertify patients
• Surescripts has postponed its December 1, 2020 deadline to require the new NCPDP script for continued ability to e-prescribe

CMS Quality Program Changes in Response to COVID-19 (2020-2021)

In addition to modifications in the “higher profile” regulations, such as the CURES Act, there have been deadline/requirement adjustments to a variety of quality programs in order to alleviate administrative burden during the COVID-19 emergency. Changes to major programs are noted below, although the list is not exhaustive.

Promoting Interoperability Program (PI)
For reporting year 2019, if a hospital did not successfully attest by March 2, 2020, the deadlines for submission of a 2019 hardship request are:

• September 1, 2020 for eligible hospitals (extended from July 1, 2020)
• November 30, 2020 for critical access hospitals (date has not changed)

Merit-based Incentive Payment System (MIPS) Eligible Clinicians
For eligible clinicians unable to submit 2019 data by April 30, 2020, weighting of all four (4) performance categories will be zero, with an automatic final score equal to the performance threshold of 45 (thereby resulting in no payment adjustment).

If eligible clinicians submit data on two (2) or three (3) of the following performance categories (Quality, PI, Improvement Activities [IA]), scores and payment adjustments will be based on that score.

Inpatient and Outpatient Services
Within a number of other quality programs, reporting delays and changes have been made. These changes may be reviewed by visiting our website for a breakdown by program. These changes are current as of this publication date and may be further delayed or modified.

NHA “Lends a Hand” to the MEDITECH Community

Last month we announced our Lends a Hand initiative, a complimentary EHR advisory service to assist the MEDITECH community during the impact of COVID-19. We are pleased to have received positive feedback from those organizations that have utilized this service, and we will continue to offer this support for all MEDITECH customers during the pandemic.

No matter the situation, whether you are short staffed due to unplanned vacancies, being stretched thin due to competing, unplanned projects, or could simply benefit from a helping hand, NHA would like to offer our assistance. Your organization’s IT staff can simply call our hotline or send an email for expert advice and insight on any MEDITECH related question. Our goal is to provide a valuable outlet and a measure of relief during this time of need.

To take advantage of this free service, any IT staff member within your organization can call our hotline at (508) 948-6791 or email us at lendsahand@navinhaffty.com.

Client Testimonial

We are pleased to share the following testimonial from one of our clients:

“The NHA revenue cycle consultant for our MEDITECH Expanse implementation was vital to our success. As soon as she started the project I felt a sense of relief. She is a wealth of knowledge with the experience and skill we needed to get where we are today. She worked evenings, nights, weekends, and did whatever it took to get the job done. I don’t know how we would have been successful without her.”
Chris Cox, Revenue Analyst
Guadalupe Regional Medical Center, Seguin, Texas

NHA Client News

We are pleased to announce we have been selected by the following organizations for their upcoming projects:

• Augusta Health, Fishersville, VA – Revenue Cycle and Interface Support
• Beacon Health System, South Bend, IN – 6.08 PP Update
• Deborah Heart and Lung Center, Browns Mills, NJ – 6.15 Proration Rules/Contract Management
• Duncan Regional Hospital, Duncan, OK – BAR Support
• Grand River Hospital District, Rifle, CO – Expanse Ambulatory Optimization
• Kingman Regional Medical Center, Kingman, AZ – Radiology Support
• North Country Healthcare, Littleton, NH – Expanse Oncology Implementation
• RML Specialty Hospital System, Hinsdale, IL – C/S 5.67 Clinical Assistance & Expanse Preparation
• San Juan Regional Medical Center, Farmington, NM – AP Support
• Signature Healthcare, Brockton, MA – Priority Pack Update and Ambulatory Project Management, Support and Provider Training
• United Medical Center, Washington, DC – MAGIC Support
• Wooster Community Hospital Health System, Wooster, OH – Expanse Clinical Assessment

Quick Notes

• NHA consultant Rhiannon Morlan and her husband began a program in their hometown of Powell, Wyoming to collect donations and provide groceries to Powell residents in need during the pandemic. “Love Thy Neighbor – Powell” has quickly grown into a program which, with the assistance of volunteers and other community leaders, is serving meals to 100 Powell residents per night. The Morlans have been recognized by the governor of Wyoming as community heroes.
• In honor of National Nurses Week, NHA client Goshen Hospital recently celebrated a mother-daughter nursing duo who have been on the front lines of this pandemic.
• Firelands Regional Health System, Sandusky, OH, describes the use of BCA to monitor COVID-19 patients.
• MEDITECH reaffirms its commitment to Virtual Visits and shares stories of its use at many client sites.
• MEDITECH recently published a CARES Act blog outlining pandemic relief options.
• All MEDITECH platforms now have the ability to access EHR data via Health Records on iPhone^®.
• Learn more about MEDITECH’s automated and paperless patient intake capabilities.
• Forward Advantage has published new COVID-19 specific resources and offers to help hospitals with workflows and secure remote access. Additionally, the latest blogpost from Lee Howard, VP of Client Services at Forward Advantage, details use cases for solutions like single sign-on and secure remote access that can help during the COVID-19 pandemic. If you are moving to or considering migrating to MEDITECH Expanse, take a look at a new series from Forward Advantage focused on creating and optimizing a mobile strategy. The first of four articles is now available.
• MEDITECH released first quarter results showing increases in revenue and operating income.

Calendar of Events

Conferences

2020 Nurse Forum: Lighting the Way through Innovation
June 17-19 (online)
Due to the COVID-19 pandemic, the 2020 Nurse Forum will be virtual. Registration is open and keynote speakers have been announced.

2020 Physician and CIO Forum
Foxborough, MA
September 16-17
Save the date. More information coming soon.

MEDITECH Webinars (all times listed in Eastern)

Mastering the Physician Mindset with MEDITECH Expanse
May 21, 11:00 AM | 60 min.
See how MEDITECH Expanse offers physicians the modern, personalized workflows they deserve, through mobile web-based navigation.

Take Control of Your Revenue Cycle with Expanse
May 27, 11:00 AM | 60 min.
See MEDITECH’s proven solution that drives revenue while improving the patients’ financial experience.

Visit MEDITECH’s new COVID-19 Webinars page for additional offerings.

NHA Careers

In these unprecedented times, NHA’s recruiting team continues to connect with dedicated individuals who are looking to the future of healthcare IT. If you are a MEDITECH professional interested in consulting, please email us at recruiting@navinhaffty.com to set up a time to discuss future opportunities.

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.