2009 International MUSE Conference May 26-29 – Vancouver, BC Canada Facility Member Educational Presentations
EMAR BMV Technical Device Considerations
Session: 2001 Scheduled: Wednesday May 27 at 1:30 pm Presenter: Charles J. Still, MBA Organization: Southwestern Vermont Health Care, Bennington, Vermont Abstract: The presentation will go into considerable detail outlining technical considerations for the best possible performance in your EMAR environment. Topics will include: Scanners Bluetooth Settings Zebra Printer Setup for 2D Motion Tablets MEDITECH on a Tablet Hardware Monitoring in the clinical environment Printing 2D Data Matrix Font Direct MEDITECH Label examples Printing Tips Armbands Generating Keyboard shortcuts via barcode scanning Known Workarounds to Bedside Scanning and how to stop them. Charles J. Still, MBA is with the Information Systems Team at Southwestern Vermont Health Care. His past work experience includes Director of Information Systems for Albany Medical Center and Systems Manager for an automotive manufacturing company. His first barcode related publication was in 1998. He has further published several articles on the topics of EMAR Bedside Scanning and Positive Patient ID and was one of the 2008 winners of the IEE Contest. His work was highlighted in the December 2008 Health Data Management Special Report on Closing the Medication Loop. Charles has a Masters of Business Administrations Degree completed in 2005 from the University of Phoenix.
So You Want to Share Your Data – Connecting to a RHIO
Session: 2002 Scheduled: Friday May 29 at 10:00 am Presenter: Alex Anderson Organization: Clifton Springs Hospital, Clifton Springs, New York Abstract: Over the past year, our facility has been going through the process of connecting to the Greater Rochester Regional Health Information Organization (RHIO). Timeline of our process and future goals we expect to achieve from our involvement will be reviewed. Topics included are: interfaces, data verification, consents, and usage.
Alex Anderson was first introduced to the MEDITECH system in the late 90's. Since then he has lead go-live teams and participated in updates in both the Magic and Client Server worlds. Currently, Alex is the Project Coordinator/Supervisor of the Analysts at Clifton Springs Hospital. The facility is currently running C/S 5.6.
Gearing Up for Scanning and Archiving
Session: 2003 Scheduled: Friday May 29 at 10:00 am Presenter: Joel Benware Organization: Alice Hyde Medical Center, Malone, New York Abstract: Like many hospitals Alice Hyde Medical Center (AHMC) wanted to bring their paper chart and electronic chart together. AHMC selected MEDITECH'S Scanning and Archiving (SCA) module so that it could introduce point of contact scanning and batch scanning of paper records into the electronic record. At the time of this conference, AHMC will be on the verge of going live with SCA and we will be sharing our experience of bar-coding hundreds of forms and getting our workflow in place for the launch of this module. Come and listen to an unbiased account of what worked well and what we would have like to see improved. Joel Benware, CIO of Alice Hyde Medical Center has been in the technology field for over ten years. Starting in K-12 education as teacher, he eventually moved on to become Director of Technology for a county school system and then later moving on as CTO of Albany College of Pharmacy in Albany NY. Mr. Benware now resides in Malone, NY where he is the CIO of Alice Hyde Medical Center.
Physician Documentation: Success with an S.O.A.P Note!
Session: 2004 Scheduled: Thursday May 28 at 3:30 pm Presenter: Kimberly Van Duyse-Atkin Organization: Prince William Health System, Manassas, Vermont Abstract: An organizational Electronic Health Record (EHR) gap analysis revealed that a key component of the Medical Record – the Progress Note – made up the bulk of the paper record. This realization inspired a specialty-based roll out of a Subjective-Objective-Assessment-Plan (SOAP) Progress Note with over 100 community-based physicians. Acknowledged challenges exist with paper progress notes and traditional transcription left disadvantages as well. MEDITECH’S Physician Care Manager module and physician documentation features provide many opportunities-customizable templates, demo recall functionality, automatic import of nonprovider documentation, results and reports, and immediate access for all clinicians in the EHR. We will discuss design and build, testing, training and implementation strategies. Challenges and realized benefits will be reviewed. We will demonstrate SOAP note completion and demonstrate the importance of specialty-based customized templates. Kim Van Duyse-Atkin earned her undergraduate nursing degree from the University of Virginia, a Master of Science in Education from Virginia Tech in 1987 and a Master of Business Administration from Keller Graduate School in 2005. In 2002, she became a Certified Professional in the Healthcare Information Management Systems Society. Her clinical experience includes medical/surgical and operating room nursing. As a healthcare IT professional with over 18 years of experience, she has led the implementation of the following advanced clinical products from MEDITECH: PCS, PCM, POM, ORM, and EDM. Most recently, Kim completed the implementation of an inpatient physician progress note with over 100 community-based physicians.
PWM E-Sign – Resolving Frustrations
Session: 2005 Scheduled: Wednesday May 27 at 2:30 pm Presenters: Carmen Guerrero and Mark Baker Organization: Citrus Valley Health Partners, Covina, California Abstract: Citrus Valley Health Partners (CVHP) implemented the Physician Care Manager (PCM) suite in 2008, which gave their providers a much easier e-sign process, making orders readable, logically sorted, comprehensive for multiple facilities, and incorporated scanned documentation which also required e-sign. CVHP resolved many frustrations among their providers, and increased use of the PCM suite, by showing providers that use of Provider Workload Management (PWM) e-sign is a much better solution for remaining compliant with their medical records. Carmen Guerrero is a Systems Support Coordinator in the Health Information Management department at Citrus Valley Health Partners with 13 years experience with the MEDITECH Magic platform. Mark Baker is a CPOE Analyst in the Information Services Department at Citrus Valley Health Partners, with 6 years experience with the MEDITECH Magic platform.
Implementation of eMAR and Bedside Medication Verification (BMV) at a Canadian Community Hospital
Session: 2006 Scheduled: Wednesday May 27 at 11:00 am Presenters: Jimmy Fung, Lina Ranieri, Cindy Van Horn, and Michael Jose Organization: Credit Valley Hospital, Mississauga, Ontario Abstract: Participants will be presented with some challenges and opportunities for increased patient safety by using eMAR/BMV. These systems can be used to ensure the "5 rights" of medication administration. Purpose To demonstrate the feasibility of an eMAR/BMV in Canadian hospitals. Methodology The Credit Valley Hospital (CVH) is a 381-bed community hospital located in Mississauga, Ontario. Studies estimate that 38% of medication errors occur at the point of administration. Virtually all of these errors will get through to the patient since there is no double check between the nurse and patient. A good bar-code point-of-care (BPOC) medication administration system will provide this check and warn the nurse of potential errors. CVH decided to implement the MEDITECH Bedside Medication Verification (BMV) module as the BPOC system. CVH is one of the first hospitals in Canada to implement a BPOC system. Difficulties encountered in during implementation included the lack of a Canadian standard medication barcode format, hardware issues, lack of awareness of the issues, issues with positive patient identification, and implementation problems. We will present our medication administration system design, solutions to the issues listed above, key indicators, pre and post implementation surveys and satisfaction surveys.
This session will focus on what can go wrong when moving from a computerized paper medication administration record (MAR) to an electronic MAR as part of a BPOC system. Nurses utilized the paper MAR for all types of communication reminders for themselves, physicians, and pharmacists. These became important tools in the medication administration process. Moving to an electronic environment removed this capability and several workarounds are developed. Result/Outcome The Special Care Nursery was our pilot site and has been live since October 2008 with plans to implement in the rest of the hospital. Conclusions eMAR/BMV is a worthwhile investment for Canadian hospitals to increase patient safety. Recommendations Hospitals are encouraged to investigate the possibility of implementing eMAR/BMV module. Jimmy Fung, Lina Ranieri, Cindy van Horn and Michael Jose were the core team for the implementation of eMAR/BMV at Credit Valley Hospital. They represent pharmacy, nursing and Information Systems.
Version 2 Allergies: Schedule the Clean-up Crew!
Session: 2007 Scheduled: Thursday May 28 at 2:30 pm Presenters: Lisa Nubgaard Organization: Frederick Memorial Hospital, Frederick, Maryland Abstract: Frederick Memorial Hospital converted to version 2 Allergies in October, 2008. The preparation needed to prepare the pharmacy for the changes was well-documented, but we were not prepared for the impact on all of the other clinical areas. Everything from registration through nursing and radiology department was impacted. This presentation focuses on the non-pharmacy areas and the preparation that is needed to lessen the impact. Lisa Nubgaard BSN, MBA is a Clinical Systems Analyst with Frederick Memorial Hospital in Frederick, MD. She has been working with MEDITECH clinical applications for the past 15 years. Her most recent projects include leading the conversion to v2 Allergies and implementing eMAR/BMV.
Using Physician Documentation as a Stepping Stone to CPOE
Session: 2008 Scheduled: Thursday May 28 at 11:00 am Presenters: Mark Baker and Carmen Guerrero Organization: Citrus Valley Health Partners, Covina, California Abstract: Physician Documentation is being utilized primarily for progress notes, and we are now finding that physicians use Physician Documentation as a first step towards use of CPOE. Mark Baker is a CPOE Analyst in the Information Services Department at Citrus Valley Health Partners, with 6 years experience with the MEDITECH Magic platform. Carmen Guerrero is a Systems Support Coordinator in the Health Information Management department at Citrus Valley Health Partners with 13 years experience with the MEDITECH Magic platform.
PLACMan – Privacy Legislation and Access Control
Session: 2009 Names: R. James Brown Scheduled: Thursday May 28 at 3:30 pm Organization: Eastern Health, St. John's, Newfoundland Abstract: PLACMan –The New Electronic Game, Privacy Legislation and Access Control Management in Eastern Health. Major impacts arise from the requirements to demonstrate active protection measures and to accommodate consent directives from individuals that limit the sharing of personal health information (PHI). Historical levels of auditing are no longer sufficient in the context of emerging and evolving regulatory environments. Federal and provincial legislation in Canada has raised the bar in the expectations of health provider organizations to protect PHI. The Canadian experience is relevant to HIPPA requirements in the American context. Eastern Health is the largest health authority in eastern Canada with 12,000 staff and a budget of $1.1 billion. Services provided encompass community, child protection, mental health, cancer care, secondary and tertiary acute care, long term care, and teaching and research. The presentation will describe the initiatives of Eastern Health Regional Health Authority to address the regulatory environment under the Personal Information Protection and Electronic Documents Act (PIPEDA) and the Personal Health Information Act (passed but not yet proclaimed): New policies, auditing protocols and procedures Major education efforts for all staff and physicians Increased communication and awareness Signed confidentiality acknowledgements by staff, physicians, volunteers and vendors The discussion will provide insights into the challenge balancing individuals’ privacy rights with the necessary information access and sharing to provide services. R. James Brown BSc MBA, Director Health Information Services and Informatics, Eastern Health, has a wealth of experience in the health care spanning clinical service management to health information, decision support, utilization management and organizational performance indicators. His work encompasses the acute care, long term care and community sectors.
Building a Bridge to EMR with Dynamic Flowsheets
Session: 2010 Scheduled: Thursday May 28 at 1:30 pm Presenter: Mike McEldowney Organization: Salina Regional Health Center, Salina, Kansas Abstract: Are you struggling with physician adoption of electronic documentation and use of an EMR instead of a paper chart? While some physicians are eager to switch, some refuse. A successful implementation of PCS and EMR has to account for both extremes and everyone in between. A hybrid system of electronic and paper access to patient data is needed to ensure that every physician has the information they need to provide patient care. Learn how Salina Regional Health Center was able to bridge the adoption gap by printing dynamic flowsheets for the paper chart using PCS data, NPR, and some custom Visual Basic programming.
Mike McEldowney is the Director of Information Technology at Salina Regional Health Center in Salina, Kansas. Mike has been working in and providing leadership in MEDITECH Healthcare IT environments for over 12 years. Prior to Salina Regional Mike was Director of IT for eight years at Delta Regional Medical Center in Mississippi. He has experience in both MAGIC and Client Server systems. He is an active leader in application support, scripting, VB programming, NPR reporting, SQL administration, and is an advocate of Open Source Software in the healthcare arena.
Where eHealth and Customer Focus Marketing Meet to Create a Modern Healthcare Delivery System
Session: 2011 Scheduled: Friday May 29 at 1:30 pm Presenter: Dawn Metzgar Organization: Fairmont General Hospital, Fairmont, West Virginia Abstract: At this presentation, you will learn: The importance of customer-focused web site development for hospitals and healthcare organizations for future viability What patients look for in online tools New innovations in web-based portal technology Steps involved for integrating MEDITECH with an online patient portal Competition among healthcare providers and facilities is increasing not only in intensity but is now coming from unexpected directions. New healthcare delivery methods designed to enhance convenience and satisfaction are attracting the attention of healthcare consumers. Independent urgent care clinics, walk-in retail clinics, are vying for market share traditionally held primarily by hospitals and primary care physicians. Instead of going to the nearest hospital, patients now "shop" among the closest healthcare options. Often, the healthcare decision is based simply on word of mouth information or the image/reputation of the facility in the community and not necessarily the quality of care or menu of services. Long-term success of hospitals is reliant on adaptability to these pressures with innovative technology and services to retain market share. More and more, the online community outstretches the traditional methods of purchasing, paying bills, and research. Online services and products are a new trend healthcare organizations cannot ignore. Baby Boomers are more tech savvy than their Traditionalist counterparts and hospital online services must evolve to reflect this difference. Additionally, facilities that primarily rely on the patronage of older patients must look for ways to create a relationship with younger generations for support in the facility's long-term viability. The session will discuss the patient online strategies available to healthcare facilities. Healthcare facilities can implement the online efforts with the existing MEDITECH component for secure patient access to their medical records, billing pay/inquiry, and registration/scheduling. Dawn Metzgar was born and raised in Fairmont, West Virginia. She received her Marketing degree from Fairmont State University in 2001. Since April 2002, she has been employed as Marketing Coordinator for Fairmont General Hospital. In this position she oversees the advertising and public relations for Fairmont General Hospital. Fairmont General is a small community hospital serving the Marion County area.
EDM / CPOE / PDOC – Past, Present, and Future
Session: 2012 Scheduled: Thursday May 28 at 11:00 am Presenters: John Lee and Troy Judd Organization: Edward Hospital and Health Services, Naperville, Illinois Abstract: Edward Hospital and Health Services has been live with EDM since early 2006. The implementation of MEDITECH’s Magic EDM system has been a challenge, but has had multiple success stories along the way. A large part of the success in the system can be attributed to the high level of involvement from the Edward Employed Emergency Room Physicians and their partnership with the information technology department. The past will provide an implementation overview including converting from the existing electronic tracker, timelines, training and development of an ED informatics medical director. The present will discuss trackers, functionality in use, nursing process, Computerized Physician Order Entry (POM), depart process and physician documentation (PDOC). The future will highlight anticipated feature enhancements as Edward prepares for focus/client server conversion. After graduating from Loyola University Medical School and residency at Cook County, Dr. John Lee, FAAEM has been a practicing ED physician for 13 years, 12 of them at Edward Hospital. He has always had a strong interest in information systems and, in particular, has worked closely with Edward Hospital’s IT department over the past three years on the design and implementation of the EDM module. Troy Judd RN, BSN, has worked at Edward Hospital for seven years. His clinical background is in the emergency room, where he worked as both a staff and charge nurse. He served as a nurse team member for the initial MEDITECH EDM implementation and is currently working in the information technology department as a Senior Application Analyst, supporting EDM, RXM, and POM/OM using EDM.
IEE Contestant Documenting Vital Signs – Can it Really Be That Simple?
Session: 2013 Scheduled: Thursday May 28 at 11:00 am Presenter: William Arnold RN Organization: Erie County Medical Center, Buffalo, New York Abstract: Downloading vital signs directly into MEDITECH sounds fantastic, but could it really be done? After doing rounds on 5-20 patients, could we really expect that with one click all the vital sign data will be entered into MEDITECH, saving our staff from having to enter this data on each patient thru PCS? The journey to accomplish this task was not always as smooth as we would have liked, but with some hard work, testing, tweaking, and an occasional new diagnosis of hypertension we obtained our goal and rolled out to the units. This presentation will discuss that process, from setting our goals to working with our vendor partners to meet those goals. Learn how our testing led to a rather conservative roll out, and learn how our best measure of success has been our staff. William Arnold BSN, RN is currently employed by Erie County Medical Center Corporation (ECMCC) as the Nursing Informatics Manager. He has worked as a staff nurse for over 20 years in the Intensive Care Units. He has been the Nursing Informatics manager since 2002. ECMCC went live with nursing documentation early in 2002, and is working on implementing all the Advanced Clinicals at present.
Successful Implementation of EDM in a Level 1 Trauma Center
Session: 2015 Scheduled: Thursday May 28 at 2:30 pm Presenter: Andrew Kwiatkowski Organization: Erie County Medical Center, Buffalo, New York Abstract: Erie County Medical Centers Corporation (ECMCC) is a 450+ bed hospital and Level 1 Trauma center. This presentation will focus on the successful implementation of MEDITECH’s Emergency Department (EDM) module. Topics will include the steps taken to redesign Emergency Department workflow (which include reception, registration, triage, room and staff assignments, and discharge), and the difficulties overcome in integrating each process. Further discussion will focus on the implementation of Non-Provider Order Management (POM) and Ambulatory Order Management (AOM/RXM) in conjunction with EDM. Andrew Kwiatkowski has 4+ years experience with clinical and Information Systems implementation. His various MEDITECH system experience includes MIS, BMV, OE, EDM, ADM and other areas.
Recovery Audit Contractor (RAC) – Lessons Learned
Session: 2016 Scheduled: Wednesday May 27 at 1:30 pm Presenter: Renee Grigg Organization: Samaritan Medical Center, Watertown, New York Abstract: The Medicare Recovery Audit Contractor (RAC) three year demonstration included New York, Florida and California. This presentation will outline the challenges this New York facility experienced and the lessons learned throughout the RAC process. A permanent and nationwide RAC program is just around the corner. Is your facility prepared? This session will provide lessons learned including RAC preparation, tracking claim reviews, changes between the demonstration project and the permanent RAC program Renee Grigg has twenty-six years of experience in healthcare finance at Samaritan Medical Center including the Accounting, Reimbursement and Patient Accounting departments. Renee is currently the Director of Patient Accounting; responsible for acute care, skilled nursing and hospital based clinic billing functions as well as admissions.
2008 IEE Winner Countess RemindMe – Text and Email Patient Reminder Service
Session: 2017 Scheduled: Thursday May 28 at 1:30 pm Presenter: Kirsty Nield Organization: Countess Of Chester Hospital, Chester, UK
A MEDITECH Client/Server Systems Disaster Recovery Solution
Session: 2019 Scheduled: Wednesday May 27 at 1:30 pm Presenter: Ed Volkstorf Organization: Augusta Medical Center, Fisherville, Vermont Abstract: Learn about a disaster recovery solution. The goals, plan, and results are highlighted including: Migration from an old server farm to VMWare Implementation of a DR solution Replacement and redeployment of various hardware devices Ed Volkstorf is a veteran healthcare IT professional who has worked for four years as the OPS manager at a MEDITECH C/S hospital. He was previously OPS manager at hospital using Cerner. His background also includes software development, DoD Navy contract work, and various other IT positions.
LAB Downtime...OH NO!
Session: 2021 Scheduled: Wednesday May 27 at 2:30 pm Presenter: Julie Cohen Organization: Chandler Regional Medical Center, Chandler, Arizona Abstract: Downtime...the one word that everyone hates to hear, especially in the LAB. Learn how the laboratory at Chandler Regional Medical Center has used MEDITECH to make downtime as pain-free and efficient as possible. This session will encompass methods for a smoother downtime, whether it is a full MEDITECH downtime or just LAB downtime. The presentation will also include how MEDITECH is used when mobile phlebotomy is down. Chandler Regional Medical Center, a member of Catholic Healthcare West, is a 225-bed acute-care, non-for-profit hospital. Julie Cohen is the LIS Coordinator for Chandler Regional Medical Center. She has been in this role for six years. During this time she has implemented three upgrades to MEDITECH and over 20 interfaces. Julie has worked as a Med Tech for 12 years and is also a CAP inspector.
Paper-Free Hospital – A Success Story of a Rural Hospital and its Quest Towards an Electronic Health Record
Session: 2022 Scheduled: Friday May 29 at 11:00 am Presenter: Alice Rogers Organization: Uvalde Memorial Hospital, Uvalde, Texas Abstract: Uvalde Memorial Hospital, an organization comprised of over 430 employees serving a population of over 50,000, is a rural hospital who is dedicated to providing the highest quality services to the counties it serves. Being a rural hospital, what then gives Uvalde its competitive edge? First and foremost, Uvalde is a thriving organization today because it is an extensive user of MEDITECH. As with any other hospitals, Uvalde still faces challenges of a large hospital but manages these challenges with a smaller staff. As a rural hospital, Uvalde was struggling with paper. We too had the aspiration of turning our organization into a paper-free environment. In this presentation, understand why we went looking for a document imaging system. What were our key drivers? As with the implementation of new technology, an organization undergoes a thorough selection and implementation process. Learn
in-depth of what these processes entailed and how you can develop a seamless process for your organization. Now being live with a document imaging system, get an insight as to where we are today. The attendees will explore how document imaging caters to enterprise wide communication and electronic documentation improving decision making and allowing for more access to in-depth information. Finally, learn where we plan to be next year as we continue on our journey towards an Electronic Health Record. Alice Rogers is a Registered Nurse who works at Uvalde Memorial Hospital as a Clinical Information Specialist. She has been in this job since September 2006. Prior to this job Alice worked as the Director of the ICU, as well as a RN in the Endoscopy, Operating Room, and Day Surgery areas. As the Clinical Information Specialist she and her team have implemented MEDITECH's EDM & BMV modules. She has also gone through three system wide updates and continues to keep up with the latest trends. She led the successful implementation of an Electronic Health Record.
Enhancing Clinical Decision Support and Making Physician and Providers Happy All at the Same Time
Session: 2024 Scheduled: Thursday May 28 at 1:30 pm Presenter: Patrick Lykins Organization: Fairmont General Hospital, Fairmont, West Virginia Abstract: Hospitals understand that physicians are one of the key pillars for clinical success. Attracting and retaining the best physicians and clinicians will make or break a hospital. The challenge is to find the right User Interface (UI) that physicians and providers would love to use. When considering information technology solutions to enhance care processes, physicians are demanding ease-of-use web solutions that would look familiar to them like AOL, Yahoo, and Google. This session will explore what one community hospital achieved when it was challenged with the task to improve physician and clinician user interface. We will share our needs assessment and findings, what we considered during the selection process, issues that were encountered and resolved during the implementation process, and lessons learned. Patrick Lykins is a System Analyst II at Fairmont General Hospital. He has been professionally designing software for over 20 years and worked as a consultant serving many industries from government to education to manufacturing and some health care. In September 2000 he stepped into a large retail company overseeing their application and database development and eventually managing the infrastructure side of IT. In September 2007 he transitioned into healthcare at Fairmont General. Some of his current responsibilities are the support of existing and new applications, web development, scripting, and training of key applications.
Development and Implementation of Global Positive Patient Identification Policy and Procedure at a Community Hospital
Session: 2026 Scheduled: Thursday May 28 at 11:00 am Presenter: Lina Ranieri Organization: The Credit Valley Hospital, Mississauga, Ontario Abstract: Value to Participants Participants will be presented with highlights of the Policy and Procedure which establishes the standardization of patient identification at point of entry, point of care, and documentation of care (order entry.) Purposes To promote patient safety. To provide mechanisms and processes for correct patient identification. To provide a corporate and standardized approach to patient identification and patient identifiers. Methodology Positive patient identification must occur across the continuum of patient care. Recognizing the importance of patient identification and taking part in ensuring the process is the responsibility of all healthcare professionals and providers. It is also recognized that the patient is an important partner in ensuring their positive identification. Registration of patient conforming with new ministry guidelines. Our hospital rollout bar-coded printable devices which have been standardized to include five unique patient identifiers. The bar-code is scanned for glucometer testing as well recently for the implement the MEDITECH Bedside Medication Verification (BMV) module as the bar-code pointof-care (BPOC) system in our Special Care Nursery Unit. The Credit Valley Hospital (CVH) is one of the first hospitals in Canada to implement a BPOC system. We will present our bar-coded printable solutions as well as key indicators as well as pre and post implementation surveys. Education was provided to all employees focusing on clinical and clerical staff via in-services, use of educational tools and posters. Public education included the new registration requirements which continue to display in all registration areas. It is the responsibility of the healthcare professional doing the initial application of the band to explain the importance of wearing the identification bands or labels. Result/Outcome The education around positive patient identification has been rolled out to the public, physician offices and hospital staff. Outcomes of this process include: Improvements in registration practice including standardization and improved compliance with ministry guidelines Increase rates of detection of near miss incidents, resulting in opportunities for process improvements Implementation of printable devices and consequent use of medical devices using barcoding Error reduction Conclusions Standardization of policies, procedures and processes for positive patient identification are a fundamental starting point for the delivery of safe and effective patient care. Processes for identification begin at the point of entry into the hospital system and do not stop until after the patient is discharged from hospital care. Printable devices, which include but are not restricted to
the use of bar-coded armbands, are an essential to the process of identification and care delivery. Policies and procedures must take into account the multiple service and documentation needs from across all services, from the inpatient acute care bedside, to the outpatient clinics and diagnostic services, and every application in-between. Challenges to development can be mitigated through engaging all stakeholders and having a clear and consistent communication plan. Recommendations Hospitals are encouraged to investigate the possibility of implementing a standardize method for patient identification. Lina Ranieri has been in the Nursing Informatics Coordinator role approximately four years, and involved in the rollout of global education as well as printable devices. Lina is the Clinical Lead for the eMAR/BMV component of the Electronic Health Record Project. CVH is live with eMAR/BMV in our Special Care Nursery as of October 2008.
Vein to Vein Tracking – A Marriage Made in MEDITECH
Session: 2028 Scheduled: Thursday May 28 at 2:30 pm Presenters: Dorothy Kasibante, Kevin Macaulay, and Wilhelm Pettersson Organization: HCA International, London, United Kingdom Abstract: In November 2005, United Kingdom Blood Safety & Quality Regulation (Statutory Instrument 2005 Number 50) was inducted into UK law. A major component of the law was the requirement for full traceability of blood products from donor to transfusion and retention of patient records for thirty years. The challenge for HCA International in London with six hospitals, a total of 749 beds and over 3,000 staff, was to implement a blood 'issue to patient' blood tracking system which met legislative requirements, including a core standard to maintain the 'cold chain' i.e. to ensure that blood products were stored optimally and that they were transported and transfused at the correct temperature. Prior to commencement of this project, all blood products tracking and recording of transfusion was a paper based system – complicated by the fact that couriers from the ventral laboratory to the hospital issue fridges were not employees of HCA. In addition, audits of paperwork revealed that despite training the paper data was often incomplete or illegible and not of the standard where evidence of regulatory compliance could be produced. To enable this project to meet fruition Information Technology & Services (IT&S) along with clinical staff worked together to source a third party system to electronically track blood products between locations (stock and issues fridges and eventually to the point of transfusion) and to ensure that they were not out of cold storage for too long. The utilization of the NMI module would bind MEDITECH and blood tracking together. Other pre-requisites for the success of this project were the implementation of staff bar-coded ID badges, patient bar-coded wristbands and bar-coding of patient prescription charts, wireless network and mobile wireless devices with bar-code readers. The partial implementation of BMV (Beside Medication Verification Module), T.A.R (Transfusion Administration Routine) within NUR 5.6 magic platform, with its greater communication with BBK module, would streamline work process for nursing staff and enhance patient safety. This presentation will show how HCA International has achieved this.
Dorothy Kasibante has been with HCA International since 2006 as Transfusion Practitioner. Prior to this, Dorothy worked as Transfusion Practitioner in Ashford & St Peters Hospital and comes from a Biomedical Scientist Background practiced at Texas Children's Hospital Kevin Macaulay has been a Business Application Analyst at HCA International for the past five years working with clinical applications. Kevin comes from a cardiothoracic ICU Nursing background. Wilhelm Pettersson has been Business Application Team Lead since 2005, specializing in applications integration. Prior to this, Wilhelm came from System Engineering background.
The Magic of Scanning
Session: 2029 Scheduled: Friday May 29 at 11:00 am Presenters: Diane Mallett, Linda Rodriguez, Georgia Carder, and Brian Halbert Organizations: Salinas Valley Memorial Healthcare System, Salinas, California Abstract: The demands of today's healthcare environment require immediate access to a comprehensive patient record anywhere and at any time. Although the development of electronic documentation is making great advancements, the remainder of the traditional physical chart does not meet these demands. Combined with space limitations, staffing constraints and the financial and environmental impacts of paper consumption, the implementation of scanning functionality to augment the patient electronic record stands out as an obvious initiative. Salinas Valley Memorial Healthcare, a 275-bed primary care facility, has implemented all of the functions of MEDITECH’s Scanning and Archiving application in a Magic 5.61 environment during 2008. The Magic of Scanning will be described in detail to set accurate expectations of an application that will have significant implications for facilities. Members of the implementation team will present detailed observations of the necessary planning, communication, and process changes that are required for a successful implementation. Functional details for the following areas will be covered: Point of Contact scanning in a decentralized registration environment. Elimination of insurance-card handling and the transfer of paper registration documents. Chart processing and scanning, the impact to HIM staff and departmental productivity, gaining efficiency to offset increased chart processing time. Moving physicians out of the HIM department by taking physician electronic signature to the next level. Electronic physician coding queries utilizing Coder Work list functionality. Salinas Valley's utilization of outside resources to maintain project focus in a busy HIM environment. Magic facilities considering implementation of MEDITECH Scanning and Archiving will gain a real world perspective of the state of application development and the significant benefits that can be gained from implementation of this application. Diane Mallett, RHIA, Sr. Administrative Director, HIM and Patient Registration Linda Rodriguez, Assistant Director, Patient Registration Georgia Carder, Assistant Director, Health Information Management Brian Halbert, Project Leader/Consultant
Med Wreck
Session: 2030 Scheduled: Thursday May 28 at 11:00 am Presenter: Hollie Raycraft Organization: Bozeman Deaconess Hospital, Bozeman, Montana Abstract: We had no real process for Medication Reconciliation. We were going live with NUR on December 2, 2008 and our JCAHO certification depended on rolling out our medication reconciliation process at the same time. We got some help writing NPR reports and got the process up and going on December 2. It was a moving target as we went through all of the revisions of the process during the month of December. We had a surgeon revolt. Come and see how it all turns out. We will share our trials and tribulations and what we learned from it all. Hollie Raycraft is an Informatics Nurse at Bozeman Deaconess Hospital. She was team leader on the NUR implementation project.
IEE Contestant Cultured Pearls
Session: 2031 Scheduled: Thursday May 28 at 2:30 pm Presenters: Carol Anne Kozik and Cris Denniston Organization: Cortland Regional Medical Center, Cortland, New York Abstract: Successful software implementation depends on the organization's willingness to adapt and commitment to patient safety. New procedures, policies, equipment, and workflow redesign are likely to meet with resistance and workarounds without a culture that supports new initiatives. Without thoughtful design and commitment to integration of safety into the culture, additional technology can actually lead to errors. In a culture of safety, pharmacists, nurses, physicians, and administrators share concerns and ideas freely and work together to create a system that benefits not only patients but also the organization as a whole. In order to develop a commitment to the system, project leaders must apply a variety of educational, technical, interpersonal, and marketing methods to integrate communication, accountability, and teamwork into everyday practice. Acquire practical tools for engaging the entire patient care team developed by Cortland Regional Medical Center. Cortland has successfully implemented several 5.62 modules including EDM, NUR, RXM, POM, and the eMAR. BMV is currently being implemented house wide. Upon completing this session, attendees will be able to: Demonstrate an understanding of change and culture to develop an implementation plan specific to their unique organization. Select strategies to create a culture of safety within the organization. Describe tools for culture change implementation. Select and adapt processes for hardwiring patient safety into everyday practice. Evaluate examples, forms, and tools to begin planning for technology and patient safety initiatives throughout the organization. Cris Denniston, PharmD, RPh is the Director of Pharmacy. She completed a Patient Safety Fellowship at Virginia Commonwealth University. Cris has a BS in Pharmacy, BS in Biomedical Computing, and a Doctorate of Pharmacy. Carol Anne Kozik, MS, RN, CS is an Informatics Coordinator and Clinical Nurse Specialist. Achievements include implementation of multidisciplinary electronic documentation, multidisciplinary rounds, and development of clinical leadership programs. Carol Anne has a MS in Nursing and a Postmasters Certificate in Nursing Informatics.
Cris and Carol Anne are both national speakers on patient safety and culture. Current projects at Cortland include BMV, CPOE, and pharmacy automation.
Cleaning Up the Master Patient Index
Session: 2034 Scheduled: Friday May 29 at 10:00 am Presenter: Roger Allen Organization: Meadows Regional Medical Center, Vidalia, Georgia Abstract: Learn how we cleaned up the MPR regardless of when the duplicate occurred. The Mess: Inherited – Duplicate medical record number brought forward from prior manual or automated systems. Moldy – Duplicate medical record numbers created on the current system since it's go live for which no action has been taken. Fresh – Duplicate medical record numbers created within the last three calendar days. We tried a manual process, but it was labor-intensive. We sought a software tool that would, with our control over the merge criteria, automatically identify duplicates to be merged. The tool should have adequate reporting capabilities and prevent further duplicates. The tool could also function as an external "Downtime" MPI for when MEDITECH is unavailable. Learn what we discovered to locate and merge over 100,000 records and how our Document Archiving System added new twists. Roger Allen, HCIS Manager, coordinates support of all hospital applications with MEDITECH users being our largest customer base. Roger has three years of experience in current position, ten prior years experience in supporting MEDITECH, and 36 total years in healthcare. He has been the IS Director at five different hospitals. Roger earned a B.S. Healthcare Services Administration and A.S. Radiologic Technology.
eCare Plan – An Evolution
Session: 2035 Scheduled: Wednesday May 27 at 1:30 pm Presenter: Ines Jowitt Organization: Lakeridge Health, Oshawa, Ontario Abstract: To anyone that has nursed or for anyone that has worked with nurses you will know that the Kardex is to a nurse like water is to a fish! They never want to "let it go". At Lakeridge Health, our progression to an electronic version of the Kardex began over five years ago. We have progressed from inputting information and printing this information to a truly electronic version. With input from the end-users we have developed an eCare Plan that encompasses: legal data (DNAR, POA); demographic information (contacts); intervention details; goals; and, a worksheet that pulls it all together. Join us as we discuss how we eliminated most of the paper and how we envision the eCare Plan
as becoming an integral part of the Transfer of Accountability framework being set up at Lakeridge Health. Ines Jowitt, RN, BScN has 20 years of experience in health care at Lakeridge Health. As a critical care nurse, Ines was involved in the content development of the electronic documentation system for Lakeridge Health Oshawa and its subsequent revisions. In 2000, she spearheaded the electronic submission of data to the Critical Care Research Network of Ontario – the first site to go electronic. Currently, Ines is a Health Informatics Consultant. This role encompasses the design, build, and support of the electronic documentation screens for all clinicians at Lakeridge Health Corporation.
Working in an Integrated Environment: Interfacing MEDITECH Lab to Other Organizations' Systems
Session: 2036 Scheduled: Wednesday May 27 at 1:30 pm Presenter: David Gibbs Organization: Fraser Health, Surrey, British Columbia Abstract: The complexity of health care in the 21st century is the primary driver for implementing electronic integration of the Laboratory Information System with other organizations. Current dynamics in Laboratory Medicine require specimens to be referred to other organizations for analysis and to have those results delivered in a timely fashion. Fewer qualified staff to handle the volume of work and the increasing use of Electronic Medical Records has made integration of MEDITECH with other organizations' systems imperative. Fraser Health is Canada's largest multi-facility organization serving 1.5 million people in British Columbia. Fraser Health Laboratory's implementation team has implemented several MEDITECH interfaces in both Magic and Client Server to other organizations as part of its strategy of a complete patient electronic health record. This presentation will cover the planning, development, configuration, testing, implementation and auditing phases of creating both orders out/results in and results out interfaces. Topics of discussion will be LOINC, HL7, privacy concerns, lessons learned and the tools and methodology that allowed a small team of analysts to successfully integrate MEDITECH Lab with other organizations' systems. David Gibbs is a Medical Laboratory Technologist who has worked in various roles as an Application Specialist, System Administrator, DBA, Help Desk Analyst, and System Analyst with several different Health Information Systems for the past twenty years. He has been working with MEDITECH at Fraser Health for the past 3½ years as a Laboratory Information Analyst and Coordinator specializing in NPR, Rules, Calculations and System Integration.
Creating a Multi-Organizational Healthcare Community
Session: 2037 Scheduled: Friday May 29 at 11:00 am Presenters: Dan Barker and Jennifer Lyle Organization: Northeast Mental Health Centre, Sudbury, Ontario Abstract: Why reinvent the wheel? Why not just make it turn just a little faster. Did you know that, in North America: $80 - $145 billion per year is spent on failed and cancelled Information System projects 25% - 40% of spending on Information System projects is wasted due to rework 40% of Information System project problems are not recognized until pointed out by end users 60% - 80% of Information System project failures are attributed to poor requirement gathering, analysis and project management If we count the time and resources spent through phases of project – conceptualization, research, planning, education, implementation, and evaluation – it amounts to a significant organizational resource impact. Why focus time and resources on things that others can already do better and quicker? Just about every system we can think of has already been designed to varying degrees. It shouldn't be about developing systems from the ground up now, but using what already is in existence and customizing it to what your really need. Joining and helping create a healthcare community, sharing information about the Information Systems / initiatives we all participate in or working together to launch new initiatives, potentially can generate higher levels of productivity, develop relationships, save time, aggravation, money and effort on application projects. Join us for a discussion on how we can all benefit by being a part of a multi-organizational healthcare community. Dan Barker R.N. B.A. has worked in at the Northeast Mental Health Centre for over 20 years. His experience has been in front-line nursing, Nursing Management and now as a Clinical Informatics Specialist and Analyst. Jennifer Lyle R.N. started her career as a front-line nurse, moved into Community Program Management, worked as a Manager in Decision Support, is the site coordinator for the Resident Assessment Instrument and is also a Project Manager in the IS department.
Trying to Avoid Drowning in an Ocean of Information
Session: 2038 Scheduled: Wednesday May 27 at 11:00 am Presenters: Dan Barker and Jennifer Lyle Organization: Northeast Mental Health Centre, Sudbury, Ontario Abstract: One (potentially) good outcome of the movement towards electronic applications and increasing technical diversity in healthcare is the accessibility to a multitude of new information and varied methods of reporting it. But how much data is too much data. How do you make sense of it and what do you do with it? With healthcare reform initiatives driving decision-making, optimizing data outputs are vital to
support hospitals to be able to facilitate the delivery of quality patient care and measure the cost, the effectiveness and efficiency of health care service activities to ensure appropriate planning management, healthcare delivery and funding. This is our story of how one MEDITECH hospital, the Northeast Mental Health Centre, worked to maximize the clinical and administrative utility and relevance of data collected by the "Resident Assessment Instrument – Mental Health" to enhance patient care and provide information for planning effective service delivery. Jennifer Lyle R.N. has worked at the Northeast Mental Health Centre for over 12 years. Her experience has been in front-line nursing, Community Program Management, Management in Decision Support, is the site Coordinator for the Resident Assessment Instrument and is also a Project Manager in the IS department. Dan Barker R.N. B.A. started his career as a front-line nurse, moved into a Nursing Management role and now as a Clinical Informatics Specialist and Analyst.
IEE Contestant Portable Documentation Templates
Session: 2040 Scheduled: Wednesday May 27 at 1:30 pm Presenter: Donnal C. Walter, MD, PhD Organization: Arkansas Children's Hospital, Little Rock, Arkansas Abstract: The concept of portability in clinical documentation templates begins with the notion that composing, editing, and reviewing documentation templates should not require the use of a specific clinical system. Instead, it should be possible to "port" templates across widely differing systems and platforms. This means that institutions can begin building templates in advance of implementing a system. Portability also implies shorter turnaround times. When templates are not required to conform to the idiosyncrasies of a given system, attention can be focused on clinical content. As the feedback loop is shortened, clinicians can afford to become more directly involved in template development. Portable documentation templates (PDTs) promote peer-review and evidence-based evaluation. We describe an XML-based syntax for representing PDTs. The resulting PDT files (XML) can be viewed in a web-browser, translated to XHTML forms, adapted to ASP web applications, or converted into other formats (such as text, PDF, RTF). Fragments of templates (sections, subsections, or components) can be exported as separate XML files and imported into other templates. PDT files can be edited with a simple text editor, a generic XML editor, or an editor customized for the PDT syntax. The structure of the PDT in this syntax is compatible with MEDITECH PCM, EDM, and MPM dictionaries on Magic or Client/Server platforms. The PDT syntax is straightforward. Templates consist of sections, subsections (header-labels), and components. Components may be free text, canned text, formatted data, or customerdefined (HTML). Alternatively, complex components can be constructed from combinations of comments, numbers, dates, times, groups, lists, or layouts. Layouts consist of headers and options; groups and lists consist of options alone. The structure is represented using XML elements, while content is given in XML attributes, particularly the "text" attribute. Although portability is enhanced by standardization, the syntax can be modified with little effort, since it too is defined in XML format. We also describe an XSL-based style sheet for translating PDTs to HTML, producing a web form simulating the desktop in PCM and other MEDITECH modules.
The PDT syntax has wide applicability, but should be of particular interest to MEDITECH sites since it is designed to be compatible with the dictionary structure of MEDITECH advanced clinical applications. A library of templates can be built and reviewed in advance of implementation, and shared among institutions across Magic and C/S platforms and across multiple versions. Donnal Walter has been a practicing neonatologist at Arkansas Children's Hospital since 1984. He is currently the hospital's Chief Medical Information Officer, and he facilitates the Pediatric Advance Clinical Interest Group (PACIG).
IEE Contestant Getting Through the Chaos!
Session: 2041 Scheduled: Wednesday May 27 at 2:30 pm Presenters: Candy Thorman, RN, Kathi Gebhardt, RN, and Pam Kuehl, RN Organization: Fort HealthCare, Ft. Atkinson, Wisconsin Abstract: Fort HealthCare (FHC) is an organization located in the Fort Atkinson, Wisconsin area, and is a rural, non-profit industry providing health care to eight-community regions. FHC incorporates the Fort Memorial Hospital and a variety of clinics, including its most recent addition, the Fort HealthCare Wound & Edema Center, located in Johnson Creek, Wisconsin which opened in October of 2008. Fort Memorial Hospital is a fully accredited, 110 licensed bed facility with a mission of providing 'excellent, compassionate care' for the people in their surrounding communities. Getting through the chaos of implementing and exceeding with technological advances in the healthcare setting must be driven by dedication, compassion, and excellent communication. In this presentation, key speakers will identify five challenging topics pertaining to implementing a Bedside Medication Verification process and an electronic-Medication Administration Record in any healthcare organization. Focus will include the following: Safety Practices and Compliance with the National Patient Safety Goals Difficult Hardware Decisions – Preparing for a Learning Curve Collaboration of Pharmacy Requirements and Resolutions Staff Education Process Statistical Turnout of Audit Reports This undertaking is not new to these speakers, as they have all presented at the Central US Regional MUSE conference in 2008. They will share challenges that come about during implementation, and they will enlighten the listener with success stories that make these technological advances all worthwhile. The speakers will focus on areas that will keep the listener engaged and eager to move forward with these advances in their own organizations. The presenters will summarize that taking on chaos in any healthcare setting challenges individuals to sync along side of 'letting go' of old practices and 'moving on' to new adventures. If you are questioning how to get through your technological turmoil, don't miss "Getting through the Chaos"! Candy Thorman, RN, Patient Care System Coordinator has been instrumental in various projects, including electronic-Medication Administration and Bedside Medication Verification. Candy enjoys the challenge technology brings and takes a multidisciplinary approach to allow for user-friendly services. Kathi Gebhardt, RN, House Supervisor has participated in building and implementing Fort HealthCare's Patient Care System, and the Bedside Medication Verification process. Kathi
enjoys educating staff in the technology process. Pam Kuehl, RN, Nurse Manager has played a part in implementation and development of numerous projects, including the recently established Nursing Informatics Council. Pam's enthusiasm to co-present derives from her passion for the organization,
Getting To The Data – A Team Approach for Beginners Using the Data Repository
Session: 2042 Scheduled: Thursday May 28 at 1:30 pm Presenter: Pat Mulberger Organization: Kalispell Regional Medical Center, Kalispell, Montana Abstract: Are you buried with requests for NPR reports and unable to meet the expectations our facility searched for a new solution? Using some new tools we enlisted the aid of super users and data junkies from various MEDITECH modules and built a team approach to getting at the data. This approach allows users to become the expert on how data is stored in the Data Repository for their modules and to take ownership of their own reporting needs. Once they pull the tables they are given tools to build powerful reports – and they don’t have to call I.T. each and every time they want a single field added or some type of formatting change. Those familiar with their areas used MEDITECH’s DR and some NPR reports supplied by IT to build dynamic reports that could be easily changed by the end-user and that held powerful drilling functions. This presentation addresses our challenges and the benefits of utilizing staff from all areas to team together as report builders for their modules. Pat Mulberger worked as a staff nurse and an Assistant Head Nurse for 20 years prior to leading the MEDITECH HCIS build in a rural facility in 1995. She became a MEDITECH consultant in 1998 and led multiple Client Server implementations. Pat expanded her IT knowledge by working in IT as an applications support resource at Kalispell Regional Medical Center and has just moved back to Nursing to do Clinical Informatics once again. Pat has published several articles on clinical implementations and has presented five times at the International MUSE convention. She is an intermediate NPR Report Writer and has been learning SQL and the tools needed to utilize the Data Repository.
Bridging the Gap: The Business Analyst Role in Implementing a Clinical System
Session: 2043 Scheduled: Wednesday May 27 at 1:30 pm Presenter: Mons Dela Cruz Organization: Fraser Health, Surrey, British Columbia Abstract: The presentation will define of a Business Analyst, as per the IIBA (International Institute of Business Analysts), and the work and expertise the Business Analyst brings to the project as reflected by BABOK (Business Analyst Book Of Knowledge) for doing business analysis. It will show how these best practices are used or seen in action – hence I am going to share my experiences while implementing MEDITECH EDM (for Client Server and Magic environment) here at Fraser Health. The Business Analyst role was identified as pivotal in the very aggressive timeline of the EDIS (Emergency Department Information System) project implementation: from August 2007 to March 2008, seven sites in eight months; two sites were Magic and five were Client Server.
Mons Dela Cruz is a Business Systems Analyst for Fraser Health Authority under the Health Informatics Group for Acute and Clinical Support. She has a degree in Business Administration majoring in Computer Science and has worked for the three Health Authorities in British Columbia (Vancouver Coastal, Interior Health and Fraser Health Authority) implementing and supporting clinical and non-clinical applications.
MEDITECH Roles-Based Menus – Conversion to Desktop Menus
Session: 2044 Scheduled: Wednesday May 27 at 2:30 pm Presenter: Janice Do Rego Organization: Credit Valley Hospital, Mississauga, Ontario Abstract: This presentation will outline the steps that were necessary in order to design and implement role-based desktop menus for over 3,000 hospital employees. Brand new menus were designed based on job roles within the organization and access given according to module needs. Previous “numeric style” menus were not recycled but were replaced with new “desktop style” menus; a variety of cascading and desktop styles were developed. Generic roles were built first and then each user’s MIS access was edited to accommodate the new menus. Going forward, this facilitates a smooth request process in Information Systems when a new user is hired in any role, program or department. NPR reports were also streamlined depending on usage and grouped together per application. Come and listen and see the various obstacles and challenges that we encountered. Janice Do Rego is an Applications Analyst at Credit Valley Hospital, Mississauga, Ontario where she has worked for almost five years. Her daily tasks include providing Access requests/changes nd to 3,000+ employees and ensuring 2 level support issues are handled. She is currently the HEAT administration and WTIS Coordinator for her hospital. She has successfully implemented electronic forms hospital-wide using Optio and continues work on EHR initiatives.