muse international Spring 2013
“How Do you Measure Up? A look at project statuses within the MUSE membership”
Plus
– 2013 International MUSE Conference Summits, Site Visit, Exhibit Hall and More! - MUSE Lanuches Community Peer Groups - Burke Rehabilitation Hospital Hosts Clinical Event
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It would be drug knowledge. Delivering deeper, more actionable insights. Enhancing medication decisions. Promoting interoperability and progress toward Meaningful Use. Even providing breakthroughs to alert fatigue with FDB AlertSpace,™ and med ordering with FDB Go-Live Med Orders.™ Find out why it’s time to rethink drug data.
Join us at the 2013 FDB Customer Seminar, at MUSE conferences, or visit us online at fdbhealth.com © 2013 First Databank, Inc.
Meet MUSE new members
Welcome Acryness, Inc.
Alder Hey Children's NHS Foundation Trust All Children'sHospital Armstrong County Memorial Hospital Buchanan County Health Center Citrix CommVault Comport Consulting Corporation Cordea Consulting, LLC Craneware, Inc. dbMotion Discharge 1-2-3 Emmi Solutions Estes Park Medical Center ExitCare, an Elsevier Company General Data Healthcare Inc. Hebrew Senior Life Honeywell Infinity HIT, LLC
PatientSafeRx
Intelligent Medical Objects
PatientWay
Interfaith Medical Center
Pattie A. Clay RMC
iSirona
Portage Health
Jones Memorial Hospital
Porter Hospital
Krames StayWell
Roger Williams Medical Center
Lane Regional Medical Center
Rouge Valley Health System
LodgeNet Healthcare
Sandlot Solutions
Meadows Regional Medical Center
St. Joseph Health
Motorola Solutions
Strata Decision Technology
Nuance Communications
The HCI Group, LLC
Oak Valley Hospital District
The Sullivan Group
Oneida Healthcare
Valley View Hospital
Oxford Healthcare IT
VMware Inc
Patientco Holdings LLC
Western Missouri Medical Center
PatientSafe Solutions
X-Factor Communications SPRING 2013
MUSE INTERNATIONAL
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• Team of consultants with an average of 20 years healthcare experience • MEDITECH’s primary integrator, providing testing, certification, implementation, and project management • Full range of technology and disaster recovery solutions including virtualization, hosting, and cloud computing
Applications
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• Full offering of application management services including NPR report writing, hosting, and monitoring • Deep expertise in all MEDITECH’s applications such as CPOE, BMV, eMAR, and revenue cycle Learn more about the MEDITECH Solutions Group. Visit dell.com/meditechsolutions or call us at 781-401-2104.
Infrastructure
Support
Dell Services is growing its MEDITECH practice and is looking for Consultants. For more information or to receive a copy of the complete job description, email meditechsolutions@dell.com.
INSIDE Spring 2013
VOLUME 5 NUMBER 1
page 17 - Burke
Rehabilitation Hospital Hosts Clinical Event
“The presentation, “CPOE physician journey admit to discharge” was well done, good discussions. ”
page 20 - MUSE
Lanuches Community Peer Groups - MAKN IT
P E E R
G R O U P
MAKN IT
"MAKN IT was a great opportunity to network and get connections that you can reach out to in the future."
Physician Summit
24
Technology Track
25
Meaningful Use Track
26
Canadian Issues
30
Black & White Anniversary Gala
31
Executive Institute
32
Articles MUSE New Members
1
How Do You Measure Up?
8
Facility Profile
10
Elmhurst Memorial Hospital
10
Murray-Calloway County Hospital
11
Heywood Hospital
12
Conway Medical Center’s 13 Successful Attestation - Meaningful Use Stage 1 in 2012 17
International MUSE Conference Highlights
Don’t Reinvent the Wheel!
19
MAKN IT Community Peer Group
20
Summits, Site Visit, Executive Institute and More!
Educational Sneak-Peek
29
Bridging The Gap From Disaster to Recovery
34
Peer Group JAM Session
39
MUSE Webinar Subscriptions
40
On the COVER
pg.8
22
Burke Rehabilitation Hospital Hosts MUSE Members
page 22 - 2013
page
2013 International MUSE Conference
Site Visit - Doctors Community Hospital 28
FEATURES
M
MUSE Conference Higlights
-
How Do You Measure Up?
A look at project statuses within the MUSE membership
Departments A Letter from the Chair By Corey Tiffyer
5
MUSE Clues Game
6
From the Desk of the CEO By Alan Sherbinin
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MUSE On-going Events
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Commercial Member Directory
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Be Sure To Book Your Ad Space NOW! DON始T WAIT.. Book early to ensure your preferred ad space in MUSE Matters
Spring 2013
Volume 5
Number 1
Publisher MUSE Board Editor in Chief Alan Sherbinin MUSE CEO Managing Editor Alicia Roberts
Any questions or comments should be directed to: Alicia Roberts Director of Education and Marketing Ph 877-491-4703 ext. 7 Email alicia@museweb.org
US Mailing Address MUSE International #173 - 816 W Francis Avenue Spokane WA 99205 Canadian and International Mailing Address MUSE International #101 - 1865 Dilworth Dr. Suite 350 Kelowna BC V1Y 9T1 All rights reserved; reproduction in whole or in part without written permission is strictly prohibited. Copyright 2003 by Medical Users Software Exchange.
MUSE is committed to assisting the MUSE Membership in identifying products and services that compliment and supplement their healthcare information systems.
A LETTER FROM THE CHAIR
Dear MUSE Members, Welcome to the Spring 2013 edition of MUSE Matters. Your MUSE staff, members and volunteers have put together an interesting edition with a focus on projects near and dear to all of our hearts. In this edition, you will read about new initiatives (such as Community Peer Groups), facility profiles, event updates, upcoming programs and more. As MUSE, our Mission is to support “a community of MEDITECH users and related professionals who interact to learn and share their knowledge and experience. Through MUSE, members network, solve problems, identify best practices, and improve performance for their organizations.” The MUSE vision is to “be the leading source of networking and education for professionals using the MEDITECH System.” In support of our Mission and Vision your MUSE International Board, MUSE Staff, and our network of volunteers are working toward several key strategic initiatives for 2013. A few of these initiatives include implementing an Association Management System, creating a new program entitled “Community Peer Groups”, increasing our MUSE social media footprint and usage, and refining our MUSE volunteer mentorship program. At the end of May it will be time for our International MUSE Conference – a networking and educational opportunity not to be missed! This year, the International Conference will take place from May 28 through May 31, 2012 at the Gaylord National Hotel and Convention Centre in National Harbor, Maryland. Our MUSE staff and volunteers have worked many hours to ensure you have yet another great conference. The conference offers educational sessions on various necessary topics such as 6.0 and higher, client server 5.65 / 5.66, NPR training, Meaningful Use, and more. Many sessions also offer continuing education units for various disciplines. Also, this year’s conference will also bring more than
CLUES
135 exhibitors in one place to demonstrate how their services and products can help you improve performance within your healthcare organization. MEDITECH will again be in attendance with optimization presentations during the conference. While I attend the MUSE conference to learn and network for my organization, this conference has always been personally fulfilling for me. I enjoy the opportunity to share my knowledge with others through presentations or peer groups but I also know I will have several ‘a-ha’ moments during my conference experience. It happens every year and I look forward to it. I also know I will leave the conference with that little golden gem to fix a nagging issue, which I cannot wait to try it at ‘home’ to see how it works. Returning to the conference every year gives me the opportunity to meet up with my MUSE friends during meal breaks, in the Exhibit hall or during the “Big” Event to discuss their organizations and where they are going next. For those still considering attending the conference - It’s still not too late to register. I look forward to seeing you all in Washington D.C.! Sincerely,
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“Want to play MUSE Clues? Simply locate the three clues
CLUES
within the magazine, then email the article or ad titles to: www.museweb.org/play_muse_clues
by June 20 2013.
A winner will be chosen and sent a $25 Amazon gift card.
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Michelle Streeter Clinical Informatics Nurse North Adams Regional Hospital North Adams, Massachusetts
is the winner of the Spring MUSE Clues game!
FROM THE DESK OF THE
CEO...
Alan Sherbinin MUSE CEO
Toll Free 1 877 491 4703 Ph 250 491 4703 Fx 250 491 4773 Email muse@museweb.org Website www.museweb.org
A Pound of Flesh Shylock: The pound of flesh which I demand of him Is dearly bought. ‘Tis mine, and I will have it. The Merchant Of Venice Perhaps Shakespeare foreshadowed the recent Samoa Air announcement. The airlines stated that a passenger’s fare would be charged by weight. When you book online, you simply enter your estimated weight, plus the weight of your baggage, and then pay the calculated figure. Well, why not just enter your ‘optimal’ weight as opposed to your true weight? The knowin’ Samoans are one step ahead of you – you must stand on the scale at the airport to have your weight verified. With the fee of approximately 42 cents per pound, a 195-pound man with a 35-pound suitcase would pay about $97 for a one way flight between islands. Sounds like a sweet deal if you have ever wanted to take your three little kids along on a trip. But not everyone would be pleased – old Elvis would pay much more than young Elvis. Is it a fat tax? Is it fair? It is an interesting concept, and it is an interesting measurement This issue of MUSE Matters focuses on measurement. How do we measure ourselves? Magic or Client/Server or 6.0? 5.6.5 or 5.6.6? Stage 2 Meaningful Use? Stage 7 EMRAM? Public or private? For profit or non-profit? Critical access hospital or multi-site healthcare entities? Enjoy the article that highlights the project statuses of several hospitals. Plus, measure your organization against the interesting results of our recent survey. This is in addition to information publicizing our great past and future events. Perhaps a “pay for what you weigh” model will be the impetus for Americans to embrace the metric system. Your 195 pounds will sound much better when Shylock, the Samoan Air scale operator, yells out “88 kilograms”! SPRING 2013
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Survey Results HIMSS Analytics EMR Adoption Model Stage
How Do You Measure Up? During the past several months, MUSE has been surveying the membership to illuminate the statuses of common healthcare IT projects, to identify facilities that are leading the industry and to determine the top projects for the next 12 months. The reason for collecting this information is to ensure that members are able to connect easily and learn from each other’s experiences, and to develop appropriate content to meet education needs. Almost one-third of the MUSE member hospitals submitted responses, which is a sufficient population sampling to reflect accurate representation and results. The survey results indicated that MUSE facilities are, as a whole, at the forefront of progression in healthcare IT.
Stage 7.....................................................1 hospital Stage 6.............................................................27% Stage 5............................................................14% Stage 4............................................................10% Stage 3...............................................................8% Stage 2...............................................................7% Stage 1.............................................................21% (N/A)..................................................................12%
Meaningful Use Attestations
74% of MUSE hospitals surveyed have attested for MU stage 1, and of the 26 % who have not – 79% are attesting this year. 75% of MUSE hospitals surveyed are working on Stage 2 requirements
CPOE Project Status
Fully implemented.............................................24% 76-99% implemented........................................25% 51-75% implemented.........................................14% 26-50% implemented.....................................18.3% 1-25% Implemented.......................................15.5% Not started...........................................................3%
Closed Medication Loop Status (CPOE + eMAR + BMV)
Fully implemented.............................................34% 76-99% implemented........................................30% 51-75% implemented........................................15% 26-50% implemented........................................11% 1-25% Implemented............................................7% Not started..........................................................3%
Patient Portal Status
No plans to implement a patient portal.................9% Have selected a patient portal vendor.................42% Have entered into a contract for a patient portal.....31% Have set up patient portal in test environment....13% Patient portal is live and patients are using it..........4%
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How Do You Measure Up?
Patient Portal Information for those planning to implement (or already have)
Clinics/ambulatory practices only - 9% Emergency department, hospital inpatient and outpatient only - 22% Both clinics/ambulatory and emergency department, hospital inpatient and outpatient information - 69%
What are the top projects in the next 12 months for MUSE member facilities?
1 Meaningful Use Stage 2 - 35 % of facilities will be working toward this goal. 2 CPOE - 28% of facilities will be implementing CPOE or completing it. 3 Patient Portal - 24% of facilities will be completing this project. 4 Meaningful Use Stage 1 - 22% of facilities will be working toward this goal. 5 Upgrade to 5.66 - 21% of facilities will be upgrading. Other top projects:
PDOC.........................................15% ICD-10......................................11% Upgrade to 6.07..........................8% Other internal or building projects...8% Data Repository...........................6% E-prescribing...............................6%
IMO...........................................6% PCM..........................................6% EHR Optimization.......................4% Business Analytics.....................4% Public Health and HIE interfaces...4% BMV/eMAR.................................4%
Implementing EDM...................4% Migration to 6.0........................3% Oncology Module.....................3% ORM........................................3% Voice Recognition.....................3%
For the sites working on Meaningful Use Stage 2, these requirements are believed to be most challenging: 1. 2. 3. 4. 5.
Patient Portal implementation Clinical Quality Measures (CQM) Reporting Transmission of Continuity of Care Documents (CCD) Integration Short timeframe for project completion
If you are interested in contacting any of the facilities who responded to the survey, please send your inquiry to:
education@museweb.org.
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Facility Profiles Elmhurst Memorial Hospital – Using an Aggressive Training Program for CPOE Elmhurst Memorial Hospital, located in Elmhurst, Illinois has been a MEDITECH customer for 12 years, currently operating on the 5.65 platform, beginning the upgrade to 5.66. By: Mike Gruber, Director, Information Services Applications, Elmhurst Memorial Hospital
Attesting for Meaningful Use Stage 1 In preparation for this initiative, a great deal of project planning and governance through senior leadership was put in place prior to project kickoff. Key objectives that were expected to be more difficult such as CPOE were started prior to our MU journey. This afforded us a smooth implementation with little challenges. A certified EHR tool was also purchased in preparation for our attestation.
Implementing CPOE We have been live with CPOE since September of 2011 - going first with our ED. The ED had a phased approach of physician documentation as well as CPOE. We took a hybrid approach where we have two environments - paper chart and electronic. We brought the ED up on CPOE first and let the system stabilize and utilized this group as our pilot. From that point we launched a voluntary initiative for CPOE throughout the organization, with physicians signing up to begin training for CPOE (November 2011) During this voluntary period, it became increasingly difficult for staff to live in a hybrid environment; electronic and paper chart. In February, 2013, the Medical Executive Committee agreed to a CPOE mandate effective October 1, 2013. An aggressive training plan is currently in place to accommodate the October 1 date. There are approximately 150 physicians live with CPOE today, and are expecting to add an additional 200 by 10/1/13.
Preparing for Meaningful Use Stage 2 We have started meeting and planning the events that need to be completed to attest for Stage 2. We are using a consultant to assist us as we did for MU Stage 1. We are preparing our checklist and utilizing a MU Dashboard to track our status for both Stage 1 and 2.
Words of wisdom for other facilities who will be attesting this year Plan extensively, develop a comprehensive communication plan and include the physician leadership throughout the process.
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Facility Profile
Murray-Calloway County Hospital Patience and Persistence are the Keys! Murray-Calloway County Hospital, located in Murray, Kentucky encountered several challenges during the past couple of years, but the lessons learned along the way paid off for this facility. The hospital went live with MEDITECH October 1, 2002, and then the Long-Term Care site on December 1, 2002. They are currently on Client/Server 5.64 SR22, and preparing to move to 5.66 during the summer of 2013. By: Regina Davison, Manager Information Technology, Murray-Calloway County Hospital
The Attesting for Meaningful Use Stage 1 The reporting was quite challenging as there were several queries that needed to be changed so that our SQL reports would run properly. It seemed like each weekly meeting we had, we came away with more and more things added to our project list. It was quite difficult keeping up with all the tallies on each of the measures, but we built a rather large spreadsheet which contained not only hospital measures but also measures for all of our physicians. We would then run reports weekly and tally them on the spreadsheet to see how we were doing. We were fortunate that we had a contracted person who helped with the initial build of the SQL reports.
Implementing CPOE It took us two tries to get CPOE up and running successfully with it. For the first go-round the latter part of 2010, we tried to implement but it failed due to several key reasons – lack of support staff not only from an IT standpoint but from the administrative side as well. We offered more group training for the physicians the first time, but found out the second time that they really preferred one-on-one training. The first try, we had no additional support, other than IT. The second time, we hired two RN consultants to be on site two weeks prior to go-live up until about six weeks after go live. Even though we failed at CPOE on our first try, we are now averaging 94 – 96% for CPOE usage on any given day since our second go live date of April 1, 2012 (yes, April fool’s day)!
Preparing for Meaningful Use Stage 2 We have started with our bi-weekly meetings for Stage 2 but we will need to take our 5.66 update and get our patient portal installed before being able to complete the necessary steps. We are running our measurement reports at least bi-weekly so that we know if there are areas that are lagging behind.
Words of wisdom for other facilities who will be attesting this year Be patient! You will encounter lots of hurdles and headaches but by including all the necessary players in your meetings, by knowing your clinical processes both inside and out, and by providing your medical staff with ample amount of support, you should succeed. SPRING 2013
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Facility Profile
Heywood Hospital – Small IS Department Did Not Impede Success
Heywood Hospital, located in Gardner, Massachusetts, has been a MEDITECH client since 1991, currently on Magic 5.64 priority pack 13. The facility also has Client/Server ITS – so is a mixed environment. By: Sandi Wiltshire, MT (ASCP), MBA, IS Applications Manager, Heywood Hospital
Attesting for Meaningful Use Stage 1
There was an overwhelming amount of information to weed through while attesting – it was a challenge to make sure we were getting all the correct and best possible advice. Other issues were the lack of physician participation, and operating with a small IS department so we had a limited amount of resources stretching our time constraints to do all the needed projects and tasks to get this done. It's a good thing I have a wonderful team who did an amazing job despite any obstacles!
Implementing CPOE
We decided to go live with CPOE in units instead of "big bang" due to the amount of staff we have in IS to support everyone at all hours and so we could "trial" it in one unit first. We went live in April 2011 with OBS/ Nursery and they were very successful right away. This included all the Obstetricians, Pediatricians, and any Primary Care Physician that would be caring for the newborn so we had a lot of physicians live in this first round. It was then rolled out the next month to Pediatrics and the Hospitalists and admitting PCP's for the Medical/Telemetry/ICU units. The last units came right after which were Psychiatric and Geri-psych units. The area we have struggled with is surgical patients coming from PACU and the process in regards to that flow. We had to make some changes in our OR module for the nurses which we just put live and are now putting the surgeons live with CPOE for their patients being admitted from the OR.
Preparing for Meaningful Use Stage 2
We are getting our 5.66 update the end of April and are in the preimplementation stages of MEDITECH's Patient Portal which will be delivered in June. We have already completed the Immunization interface for Stage 2 and our currently working on our Syndromic Surveillance and Lab interface. We had previously reported these as NPR reports via FTP for years but are converting to HL7 interfaces with a vendor’s help. We are in the beginning stages of IMO implementation as well. We feel we are planning ahead and more experienced this time around with Stage 2 to have an idea of what lies ahead of us and know it is a lot of work, but we also have more support from leadership to help us get there.
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Words of wisdom for other facilities who will be attesting this year • Build according to the "suggested" ways of your HIS system because when you get to the next stage it will help you be already one step ahead.
• You need physician support, which for us was difficult. • A contact at your HIS and other vendor for interpretation and questions is key. • Executive support is vital so when others in the organization are requesting your resources and time for projects, the users understand that Meaningful Use is the top priority. • We have a Meaningful Use Dashboard which helps us to monitor our status at any given time, store documents and links, and is a key piece of our tracking and reporting.
Conway Medical
Attestation Meaningful Use Stage 1 in 2012 Facility Background
Conway Medical Center is a 210-bed, acute-care facility located near Myrtle Beach in the largest county in South Carolina. The private, nonprofit hospital also operates a long-term care facility, wellness center and physician offices, and employs a staff of approximately 1,300 and more than 180 physicians. They have gone paperless in the Medical Records Department and physicians have on-site /remote access to patient’s charts as well as electronic signature capabilities. Many of the disparate systems (Emergency Department, Surgery, EKG, etc.) are set up with Optical Character Recognition (OCR) to feed documents directly in the hospital’s legal EHR which is a major return on investment by allowing users to focus on other tasks instead of manually scanning the documents in the document imaging system. SPRING 2013
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Conway Medical Center’s Successful Attestation Meaningful Use Stage 1 in 2012
The Plan This patient centric, forward thinking facility set a goal to attest for Meaningful Use Stage 1 at the end of the third quarter in 2012. Many core set and menu set objectives were attainable - however there were a few gaps that needed to be filled. To close these gaps and ensure a successful attestation to CMS, Conway Medical Center enlisted the help of an equally forward thinking healthcare IT vendor.
The Implementation From contract signing to Live date, an aggressive but attainable timeline of a mere nine weeks was agreed upon. Both Conway Medical Center and the vendor were committed to the project. After a thorough gap analysis, the vendor helped Conway Hospital analysts to document their current workflow and provide best practice recommendations. They then provided a detailed road map of what was needed, where it was needed and implemented solutions to meet their goals. Through a collaborative effort with other vendors, meeting Meaningful Use requirements became attainable. To maximize the time allotted, three projects ran in parallel, each being worked upon simultaneously by the dedicated teams. 1. Clinical Quality Measures (CQM) Reporting 2. Release of Information (ROI) with Continuity of Care Documents (CCD) 3. Transmission of CCDs to South Carolina Health Information Exchange System All projects successfully went live, as scheduled, on July 1, 2012. Constant communication was a key factor but also keeping the momentum going was imperative. Both
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teams made this project their priority and took ownership of their contribution. Daily to start, then weekly webinars were held. The Conway team gained a thorough understanding of the products and made educated decisions, always with attention to minimalize the impact of these changes on their end users.
Clinical Quality Measures The first key initiative was the implementation of the Clinical Quality Measure (CQM) application. Conway’s existing data warehouse, previously used primarily for business intelligence reports, needed to be expanded to include CQM reporting capability. Within two weeks, Conway and vendor teams met five times. The Conway team had the perfect combination of multidisciplinary members that could make decisions and take action, whilst the vendor team covered all aspects of software and hardware requirements, utilizing experts from several departments. The result was the compilation and execution of a workable plan to incorporate existing data elements or create the required Clinical Data Queries (CDQs) in the application most convenient for data capture. When the CQM test system was configured, joint testing sessions were conducted with various team members admitting patients, entering documentation, test results, and medications. As a result, CQM was able to capture the MU specific data from various applications including Admissions, Order Entry, Nursing Documentation, Pharmacy, and more. The testing scenarios tried to capture as much as possible of the complex variety of CDQ combinations that could occur. After each testing session, the system was tweaked to optimize performance and accuracy. Issues and change requests were handled promptly so that the system could be retested immediately.
• The next healthcare provider will not have to guess about a patient’s allergies, medications, or current and recent past diagnoses and other pertinent information. For the next two months, Conway rolled out the planned and thought out changes to the end users’ workflow. The evidence of user acceptance was in the performance rates - one measure was 89.47%.The compilation of live data produced a statistical analysis that was reviewed in depth before the submission process began.
Release of Information for CCD and Health Information Exchange The Electronic Chart Management (ECM) system was augmented to include Release of Information (ROI) with Continuity of Care (CCD) to provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies, and procedures) upon request within three business days. The vendor worked with Conway to implement this feature as well as provide recommendations on how to market this feature to the patients to obtain a summary of their care. Within this project the Continuity of Care document was configured to successfully transmit to South Carolina Health Information Exchange (SchiEx). This enables doctors, hospitals, and other health care providers to securely share electronic medical information or "health facts" when needed for a patient's care; meeting the Meaningful Use requirement for the capability to exchange key clinical information. The collaboration between the vendor, Conway, and South Carolina government was successful, to provide the following benefits to the patients as well as the hospital by implementing the CCD feature:
• The next healthcare provider will be informed about the patient’s most recent healthcare assessment and services. • The next healthcare provider will be informed about recommendations of the caregiver who last treated the patient. • As patient demographics will be provided, time and effort will be saved by not having to repeatedly ask a patient for demographic information in detail. Rather, it can be verified, which takes less time. • A patient’s insurance status will more easily be established. Over time, this can be expanded within the system. • Costs associated with the patient’s care will be reduced, for example through avoiding repetitive tests and basic information gathering. • The effort required to update the patient’s most essential and relevant information will be minimized Conway Medical Center successfully attested to Meaningful Use Stage 1 the end of September, 2012.
By: Mickey Waters, IT Director and HIPAA Security Officer, Conway Medical Center
Hear more about this story at the 2013 International MUSE Conference, as Mickey Waters presents, Clinical Quality Measures for Successful Meaningful Use Attestation. SPRING 2013
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Burke Rehabilitation Hospital Hosts MUSE Members Bustling White Plains, New York served as the backdrop for attendees from 13 different facilities who gathered on April 3 to learn about mostly clinical topics ranging from CPOE and PDOC to ORM and clinical attributes.
Burke Rehabilitation Hospital hosted the event, which was facilitated by Cathy Dwyer, CIO at Burke, Carole Weinstein, at The Valley Hospital and Carol Bergemann at Chilton Hospital. “I found a lot of value in event, especially the networking opportunities – I was introduced to handful of attendees by others in my group. I particularly enjoyed inking faces to names that you see all over listservs, and also the discussions with peers – different sites, often same issues. The presentation, “CPOE physician journey admit to discharge” was well done, good discussions. Also, I must add that this was a beautiful campus and was easy to travel. Burke hosts were very kind and very helpful, food was good, and exhibitors were gracious as well. Michael Moore RPh, Pharmacy Information and Systems Coordinator, The Charlotte Hungerford Hospital “This event provided great educational sessions with audience interaction. There were multiple solutions for common challenges. My favorite aspects were: • • • • • • •
Seeing detailed screen shots of workflow; One day, drivable location; Two or three sessions running simultaneously; Presenter introduction with facility information; MEDITECH was there; Small intimate focus of vendors; There was plenty of time between sessions to network, meet people, and visit the vendors.
Also, a one chance conversation with another attendee paid for my trip. All the education sessions were frosting on the cake! Thank you MUSE and thank you Burke Rehabilitation Center.” Jon Nolin, Pharmacist, Northeast Health SPRING 2013
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“I found great value in the event. The sessions were loaded with timely information that can be utilized immediately. The event was very well organized, information packed and my colleagues and myself walked away feeling energized by the speakers.” Margaret Teardo, Manager of Clinical Informatics The Charlotle Hungerford Hospital “The event was valuable in that there was plenty of opportunity to speak with customers, M MEDITECH staff and representatives from the other vendors in attendance. The MUSE coordinator and Burke Rehabilitation Hospital CIO did a phenomenal job of getting participants to interact with the vendors and discuss solutions. Burke Rehabilitation Hospital did a phenomenal job organizing the event. It provided the opportunity for participating vendors to engage with customers in a collaborative environment. Customers could solicit information, discuss strategy and work- flow challenges with no pressure to purchase solutions. Vendors were afforded the ability to foster existing customer relationships and forge new ones. Jeannene Austin, Product Manager, Forward Advantage
“It is always valuable to connect with peers and share information. I particularly enjoyed the presentation on the data and attributes, as it was interesting and useful.” Kelly DeQuatrro, EHR Administator, St. Lukeʼs Cornwall Hospital
“The event was very informative. Even though we use a 6.x platform (not all of the functionality was the same), we had a chance to network with other hospitals and get some ideas on what we kinds of things we can implement to improve workflow and documentation. The ability to network and meet with other organizations struggling through some of the same issues was the best aspect of the event. Overall, the event was everything that I expected it to be; it was a great educational and networking experience.” William Chen, Senior Clinical System Analyst, St. John's Episcopal Hospital
Thank you to Burke Rehabilitation Hospital for hosting the event, and to Cathy Dwyer, Carol Bergemann and Carole Weinstein for facilitating. Also, thank you to the event exhibitors: Dell Services, Forward Advantage, Iatric Systems, Polaris Strategic Solutions, Summit Healthcare Services.
Thank you to the event sponsor, Sedona Learning Systems.
M P E E R
G R O U P
When questions or issues arise do you rely on an e-mail list serve or a handful of contacts you know for help? What if you had a familiar community where you could go at any time and learn from those who are in your shoes?
Partner with your peers to create solutions and grow together. Learn from each other’s successes and experiences. There is value in networking and value in identifying local experts.
The first step is to apply to become a Community Peer Group Leader. This leader is an individual who is committed to the success of his or her group. This person organizes meetings, identifies educational needs within the group and serves as the representative for initiatives.
Submit your Community Peer Group Request to: education@museweb.org.
The Leader must: 1) Be an active MUSE member
What is a Community Peer Group? A CPG is exactly that – a group of individuals, working toward the same goals, comprising a community that joins together to solve issues and create best practices. How are Community Peer Groups different from regular Peer Groups? The Community Peer Groups are not module-focused. They can be multi-topic, or focus on one topic, rather than a module. Also, Community Peer Groups are structured geographically so that members can easily meet and connect with each other regularly. Who can attend a Community Peer Group meeting? Attendance is limited to Facility Members and sponsoring Commercial Members. A MUSE Community Peer Group enables you to: • connect regularly with your local MUSE peers to learn from each other, share your experiences and improve your facilities. • engage more effectively with your neighboring MUSE members. • identify local topic and subject matter experts. • discuss pertinent topics in a more specific and detailed atmosphere – through teleconferences, webinars, face-to-face meetings and publications. • leverage MUSE resources to organize, plan and stage your meetings.
2) Obtain supervisor permission 3) Understand the mission and vision of MUSE 4) Have the ability to work with volunteers 5) Be able to identify educational needs of the group 6) Coordinate various projects 7) Facilitate other potential meetings 8) Identify facilities within the area to participate, even they if not MUSE members 9) Determine and prepare the educational content and agenda for at least one annual face-to-face meeting, recruiting presenters if needed 10) Lead webinars or teleconferences 11) Submit and manage funding requests 12) Communicate to group members 13) Document group activities (i.e. articles)
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M P E E R
G R O U P
MAKN IT
MAKN IT means Missouri, Arkansas, Kansas and Nebraska Information Technology – together this group is MAKN IT work! Golden Valley Memorial Hospital hosted the first MAKN IT meeting on April 16 in Clinton, Missouri. Attendees from neighboring hospitals gathered to discuss local issues and hear about Meaningful Use updates for both Stage 1 and Stage 2. "I'm so grateful for this event and for this group. With so much to do, it's wonderful to hear how others intend to tackle things."
Kim Tilley, Citizens Memorial Hospital
"Great meeting with like-minded individuals with common IT struggles and goals." Nicki Rothove, Ozarks Medical Center
"MAKN IT was a great opportunity to network and get connections that you can reach out to in the future."
Samantha Emry, Lake Regional Health System
“Very helpful! Lots of clarification & very good to be able to network with others. Really enjoyed the day & the topic. A great time of networking & discussion with peers.” Diann Goens, Capital Regional Medical Center
"Networking with other regional hospitals was great! Big success! Thank you!" Sonya Pitts, RN, White River Health System
“Collaboration with others who are working toward the same goals makes for a great meeting - I learned a lot and made awesome new contacts!" Karrie Ingram, Citizens Memorial Hospital
"Great to know there are so many contacts close to home and now I have a face to go with that name." Nancy Kuse, Lake Regional Health System
"This group was the perfect environment for meeting other MEDITECH users and making valuable contacts. I will definitely be reaching out to others who have gone before us and hopefully offering help to others with our experiences." Toni Kueffer, Capital Regional Medical Center
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“Awesome networking, looking forward to continued connection opportunities. Well organized, close to home, and just the right amount of people." Angie Berendzen, Capital Regional Medical Center
“Great information for stage 2 in the Midwest!” Teresa Tilly, Western Missouri Medical Center
"Networking with other MEDITECH users/experts in our own "backyard" is a great opportunity and very useful for getting insight on projects that others may have already accomplished." Sheila Warren, St. Genevieve County Memorial Hospital
"The networking contact with MEDITECH experts in our geographical area is absolutely invaluable. I loved the smaller group format!" Judy Schmider, Ste. Genevieve County Memorial hospital
“A smaller, more demographically similar group allows for meaningful discussions. Well informed group of presenters! Thankful for MEDITECH presence & knowledge on MU subjects.” Cindi Lockhart, Citizens Memorial Hospital
"Great time to network with users in our region."
TJ Temple, Ozarks Medical Center
Thank you to the group leaders, Alexa Thompson, Clinical Systems Analyst, Golden Valley Memorial Hospital and Kim Maples, Systems Analyst, Citizens Memorial Hospital
Also, thank you to Formfast for sponsoring the event.
Automating Hospital Workflows
The tentative date for the next MAKN IT meeting is October 15, 2013.
Watch the MUSE website for more details. SPRING 2013
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CONFERENCE HIGHLIGHT
Imagine a room filled with your peers and experts in your field just waiting to speak with you and share their stories. Or perhaps you have discovered a breakthrough solution and youʼd like to pass along your information to help others. The 2013 International MUSE Conference is the perfect venue for these encounters!
Some of the highlights of the conference are: • • • • •
A variety of Summits focusing on current hot-topics Track-specific sessions to easily identify areas of interest A Site Visit to Doctors Community Hospital A bustling, information-rich exhibit hall A jam-packed educational line-up offering continuing education credits to several disciplines • A fun-filled ʻBig Eventʼ designed to encourage peer interaction in a relaxed setting But, donʼt take our word for it! Hereʼs why your peers are attending:
CONFERENCE HIGHLIGHT
"I have participated in many previous MUSE conferences, and would argue that they enable not only the best method of networking with other MEDITECH facilities and users, they also provide the most comprehensive collection of relevant, interesting, useful, and educational information around. I am in the midst of our Magic PCM implementation and am particularly interested in learning how others have approached their CPOE and Physician Documentation projects." Julie Carlson Information Systems Senior Analyst, Cascade Valley Hospital and Clinics
"We find the right mix of vendors, professionals from peer MEDITECH hospitals, and beneficial educational opportunities. We are converting to MEDITECH 6.06 on April 1st, and taking 6.07 in August, so knowledge gain on both of these versions is critical for us." Steve Shirley VP IT / CIO, Parkview Medical Center, Pueblo, Colorado
“I attended my first and only International MUSE conference about five years ago and found it to be one of the most practical IT conferences I’ve ever attended. We’re all there to learn from each other and to strive to make improvements to our MEDITECH systems. This year, not only do I plan to learn from my peers, but share as well by presenting a session on BMV in the Emergency Department. I hope to glean lessons learned on PDoc build and implementation as well suggestions to streamline the discharge process for physicians and nurses. However, I know without a doubt that I will learn more than that!” Nancy A. Russell MS, RN-BC, CPN, Nurse Informataticist, Cook Children’s Health Care System
Take a look for yourself at the schedule and register for the “most practical IT conference” you can attend.
www.museweb.org/2013_international_muse_conference_washington_dc
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CONFERENCE HIGHLIGHT
Join six physician thought-leaders who contribute varying areas of expertise and experience as they explore Clinical Decision Support – Pursuing Best Practices.
Make plans to attend these presentations by the panelists to earn one Continuing Medical Education credit:
P H Y S I C I A N
“Iʼm So Tired of Alert Fatigue” Dr. Jeff Sippel
Co-CMIO Centura Health Englewood, Colorado
Dr. Larry Losey
CMIO Parkview Adventist Medical Center Brunswick, Maine
Presenter: Dr. Andy West Organization: Dearborn Advisors
Case Studies in Emergency Department Optimization Presenter: Dr. David Whitling Organization: Boulder Community Hospital
Going the Distance: The Transition from Paper to an Electronic Medical Record in the ER Dr. David Whitling
ED Physician Champion Boulder Community Hospital Boulder, Colorado
Dr. Andy West
Physician Executive Dearborn Advisors Santa Monica, California
Presenters: Angela Schroeder and Dr. Charles W. Olson, Jr. Organization: Stillwater Medical Center
Application for CME credit has been filed with the American Academy of Family Physicians. Determination of credit is pending.
Thursday, May 30, 2013
Attendance at the Physician Summit is included with your conference registration.
Dr. Charles Olson
CPOE Champion Stillwater Medical Center Stillwater, Oklahoma
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Dr. Reid Coleman
CMIO for Evidence Based Medicine Nuance Communications Rehoboth, Massachusetts
MUSE INTERNATIONAL
Attendee Registration
The Physician Summit is generously sponsored by:
TECHNOLOGY TRACK
Join us for an array of educational presentations focused on technical issues. Plus, network with these two prominent CIOs, and other technology experts, during scheduled forums:
CONFERENCE HIGHLIGHT
GET ONTHE RIGHTTRACK –THETECHNOLOGYTRACK!
Ken Kupetsky, VP/CIO, St. Mary’s Healthcare System for Children, Bayside, New York Bill McQuaid, CIO, Parkview Adventist Medical Center, Brunswick, Maine
Presentations … The Lightning Round: Six Technologies Impacting Healthcare IT
Join the Park Place International team for discussions on evolving technologies: Jim Fitzgerald, Joe Kelly, Matt Donahue, Rob Bruno, Mark Middleton, and Jayson Stokes.
R UR DOCS TXTING?
Ed Ricks is the CIO at Beaufort Memorial Hospital, Beaufort, South Carolina.
iPads for Everyone? How to Select the Right Tool for the Job
Designing a Robust IT Infrastructure
Jason Wilson works at Ozarks Medical Center. He has over 15 years of IT experience, with 13 years focused on healthcare IT.
Business Continuity and Disaster Recovery for MEDITECH Client Server Environments
Stephen Cellini is the Vice President of Operations at Versaworks.
MEDITECH Disaster Recovery: Real World Disasters and Key Lessons Learned
Chris Welch, with BridgeHead Software, is an expert in MEDITECH Backup, Archiving, and Disaster Recovery/Business Continuity.
Linda Hatton is the Senior Director, Information Systems at Holland Bloorview Kids Rehabilitation Hospital.
Data or Voice - Which Comes First?
For Your Eyes Only: Best Practices for Balancing Privacy and Productivity at Memorial Healthcare
Using Mobile Devices to Collect Patient Information
Frank Fear is the VP IS at Memorial Healthcare.
Martha Sullivan is the CIO at Harrison Memorial Hospital in Cynthiana, Kentucky.
Josh Johnston is the Integration Specialist at Jordan Hospital in Plymouth, Massachusetts.
Attendance at the Technology Track is included with your conference registration. There is no additional fee. The Technology Track is generously sponsored by Park Place International SPRING 2013
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CONFERENCE HIGHLIGHT
You can benefit from the Meaningful Use Track at the 2013 International MUSE Conference! Meaningful Use 101 In this presentation, we will cover the basics of Meaningful Use and Stage 1. We'll discuss the origins of Meaningful Use, how it impacts hospitals and physicians, reporting options for meaningful use, and how to meet the Meaningful Use Stage 1 measures using MEDITECH. We'll also discuss the changes to Stage 1 Meaningful Use that were published with the Stage 2 Meaningful Use rules. Presenter: Denni McColm is Chief Information Officer for Citizens Memorial Healthcare Meaningful Use 102 This presentation will cover the new measures required to meet Meaningful Use Stage 2 in 2014. We will discuss the differences in Meaningful Use Stage 1 and Stage 2 and when hospitals and physicians will need to be ready to meet the new measures. Learn, in detail, the measures that are expected to be most challenging to meet, including Transitions of Care and Patient Online Access. Along with a review of the measure details, we will discuss strategies for meeting those measures using MEDITECH and project planning for success. Presenter: Karrie Ingram is the Project Manager for a HRSA Rural Health IT Network Development grant; assisting Citizens Memorial Healthcare and eight network partners in implementing the processes needed to meet the Meaningful Use requirements. Meaningful Use 103 Stage 3 Meaningful Use is already in the works. We will give you a preview of what has been published already and what we foresee for Meaningful Use going forward as we enter the next phase of Meaningful Use. In Stage 3, the incentive payments end and we enter the penalty phases of the Meaningful Use program. You won't want to miss this opportunity to get an understanding of the likely framework for Meaningful Use in the future. Presenter: Pamela McNutt has been in the field of healthcare information technology for 31 years, the last 20 of which in the role of Chief Information Officer (CIO). She is currently the Sr. Vice-President and CIO with Methodist Health System in Dallas, Texas.
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Presenter: Gerald Greeley has been the Director of Information Services at Winchester Hospital since 1998. Equipping Your EHR with Integrated Patient Education Resources to Achieve Quality Initiatives Equipping your EHR with high-quality resources to deliver effective patient education is essential to achieve Meaningful Use. This presentation will review the MU objectives related to patient education as well as highlight considerations when choosing a patient education vendor. We will discuss the benefits of integrated patient education and we will share implementation best practices and observations.
CONFERENCE HIGHLIGHT
Surviving a Meaningful Use Audit Join us for a discussion on the experience of a MU Stage 1 CMS audit. We will review the audit process and what was learned about how to prepare for one in the future.
Presenters: Kathryn Wohnoutka RN, LAB/ITS/EDM/PD Clinical Systems Analyst, has been employed by Citizens Memorial Healthcare since 1995. Laura Harter has worked in the healthcare marketplace for 19 years and for the last five years she has been a product specialist with Truven Health Analytics. Clinical Quality Measures for Successful Meaningful Use Attestation. Conway Medical Center set a goal to attest for Meaningful Use Stage 1 at the end of the third quarter in 2012. To ensure a successful attestation to CMS, we faced more than one challenge as reporting Clinical Quality Measures requires collecting data elements from numerous systems. Learn how we were able to attain our attestation goal on a very tight timeline. The journey's emphasis was on commitment, cooperation, collaboration, and communication. Presenter: Mickey Waters has been a CIO/IT Director for over 20 years and his current employment at Conway Medical Center spans nine years. Meaningful Use Compliance Audit Manual Now that you've captured the Meaningful Use compliance information, how will you organize it into an easily usable resource if you are audited? What items will you need to prove that you did indeed meet Meaningful Use criteria? This presentation will provide clear examples of how to create an audit friendly attestation manual where you can document your facility's Meaningful Use compliance. Presenters: Michael Gardner is currently a Senior Consultant with Cornerstone Advisors Group. Chris Blakemore has over 25 years of healthcare experience including Associate CIO for CHRISTUS Health. Meaningful Use Stage Two - The Journey Continues The presentation will focus on reviewing the Stage Two requirements along with different ways that organizations can meet the objectives. The presentation will include both MEDITECH and application information plus operational approach and structure necessary to complete the implementation. Gain a better understanding of the Stage Two requirements and ways to meet the objectives. Presenter: Craig McCollum is the MEDITECH Practice Director for Vision Consulting.
Attendance at the Meaningful Use Track is included with your conference registration. There is no additional fee. The Meaningful Use track are generously sponsored by SPRING 2013
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CONFERENCE HIGHLIGHT
See it Live!
2013 International MUSE Conference Site Visit Doctors Community Hospital presents:
Challenges and Triumphs in 6.x Doctors Community Hospital has been a MEDITECH site since 1994, first on the Magic platform and, since December of 2011, using 6.05. During the past year, the facility has experienced a variety of challenges, and triumphs, including: • hospital-wide, mandatory electronic documentation for all physicians • successful Meaningful Use attestation • the new HR application • a new supply system • first-ever CPOE go-live on inpatient units • successful completion of first Joint Commission survey since converting to 6.0
This site visit describes in detail these projects, including breakout tracks and department/unit tours: Physician Track: Achieving 100% electronic documentation and (almost) 100% CPOE
Ancillary Track: Show and Tells with IT and Department Teams
• discussion with the PCM Implementation Team and Physician Champions • shadow physicians as they make rounds to observe first-hand documentation and ordering in MEDITECH.
• LIS: Adapting to the differences • PHA: Integration – Building for CPOE: Hard lessons learned • ITS: It should be “Information Transfer System”. Everything goes through ITS. • PACS: Interfacing with 6.0
Network and Hardware Track: Making the most of virtual servers and desktops in the MEDITECH 6x environment • discussion, Q&A, and Show & Tell with the Network Team
Nursing Track: Meeting evidence based practice through care plan documentation • discussion with Nursing Clinical Documentation Team • Nursing Units tours
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Financial Track: Lessons learned and a few new items • HR: A brand new application • MM: Implementing a new supply system • B/AR: Conversion lessons learned
Register Here!
CONFERENCE HIGHLIGHT
Of course you do! Whether you’re a nurse, pharmacist or physician, MUSE has CEs for you. During the 2013 International MUSE Conference, many sessions have been approved for continuing education credits.
Nurses: 46 sessions offering Continuing Nursing Education (CNEs). Individual sessions that have nursing CE are indicated by
Pharmacists: 12 sessions offering Continuing Education Units (CEUs). Individual sessions that have been approved for pharmacy CE are indicated by
Educational Review Systems is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmaceutical education. MUSE International is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
Physicians: 21 session applications have been filed for Continuing Medical Education (CME) credit with the American Academy of Family Physicians. Determination of credit is pending. Individual sessions with physician CME are indicated by
CLUES
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MEDITECH Customers: $43 Million collected 5.2% Cost to collect
Automated campaigns for accounts receivable deployed from within your MEDITECH B/AR system Visit us at MUSE 2013 Booth #539
2012 Aggregate Results
640 West 4th Street Winston-Salem, NC 27101 | 800.942.2995 | ccicollections.com/muse SPRING 2013
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CONFERENCE HIGHLIGHT Did you know that MEDITECH has a separate code for Canada to ensure the MEDITECH HCIS meets Canadian regulations? Do you remember the old days at the International MUSE Conference when we had time put aside for Canadian attendees to get together? Well … itʼs time us Canadians had a blast from the past and got together once again. Corey Tillyer, your MUSE Chair and Canadian MUSE Board representative, will lead a Canadian discussion. Join your Canadian peers to discuss Canadian issues! The MUSE Community Peer Group model for Canada Advanced Clinicals – is Canada falling behind? Canadian regulations for MEDITECH’s HCIS An overview of MEDITECH’s new organizational structure, service and support model presented by special guest Patricia Pacewicz, Director Client Services, MEDITECH, responsible for Canada. Is it ‘colour’ or ‘color’?
If there is time, we will watch a rerun of the Canada vs. Russia hockey game while eating back bacon! In all seriousness, join us for a Canadian Peer Group meeting at the 2013 International MUSE Conference. Please send your Canadian topics, issues, concerns, areas of interest, etc. to chairperson@museweb.org and letʼs have a Great White North conversation – EH!
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Corey Tillyer is the Director of Health Informatics Advanced Clinical Systems with Fraser Health Authority and your MUSE Board Chair. Corey has worked in Health Informatics and with MEDITECH since 1995. Corey's background in nursing along with a Graduate degree in Healthcare Leadership helps her to bring together the clinicians needs with IT's ability to support those needs. Patricia Pacewicz is a Registered Medical Technologist with a Masters in Business Administration. In her twenty years at MEDITECH, she has worked in various capacities starting with the Laboratory Implementation group. Today, Patricia works under the direction of Vice President, Helen Waters in her role as Director of Client Services for the Magic and Client Server platforms supporting Canadian customers. She is co-director of the Patient Safety Review Board and is actively involved in nursing and physician outreach and industry initiatives.
The Canadian Peer Group meeting is set for Friday May 31 at 9:30 am as part of the 2013 International MUSE Conference.
CONFERENCE HIGHLIGHT
Join us for the Black & White Anniversary Gala! Celebrate 30 years of MUSE with an evening of food, fun, and fox trotting! Put on your finest formal black or white attire! Enjoy the sounds of the big band! Prizes for the best (black & white) dressed! Preferred admission to those dressed in black or white.
6:00 pm – 10:00 pm Potomac Ballroom (onsite at the Gaylord National Resort) There is no additional registration or fee. Admittance is included with your conference registration. You must wear your conference nametag to gain entry.
Generously Sponsored by
and their Partners
Automating Hospital Workflows
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CONFERENCE HIGHLIGHT
Overwhelmed with plans, projects, and priorities? Let MUSE help you stay ahead of the curve.
MU S
EXECUTIVE INSTITUTE
Attend the Executive Institute at the 2013 International MUSE Conference to hear from industry experts on such topics as clinical quality measures, HIT-related advocacy, Meaningful Use, and more. Plus, hear from MEDITECH regarding current issues.
Presenters Pamela McNutt
Chantal Worzala
Sr. Vice-President and CIO Methodist Health System, Dallas, TX Topic: Meaningful Use audit from a policy perspective
Director of Policy American Hospital Association Health IT Network Topic: HIT-related advocacy
Gerald Greeley
Helen Waters
Director of Information Services Winchester Hospital, Winchester, MA Topic: Surviving a Meaningful Use audit
VP Client Services MEDITECH Topic: Customer service
Rob Anthony
Lisa Leary
Health Insurance Specialist CMS Office of E-Health Standards and Services Topic: Meaningful Use
Senior Marketing Consultant MEDITECH Topic: EMRAM Stage 7
Dr. Zahid Butt
Denni McColm
CEO Medisolv Topic: Clinical Quality Measures
CIO Citizens Memorial Healthcare, Bolivar, MO Facilitator
The Executive Institute is generously sponsored by 32
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CLUES
What’s hot for MEDITECH sites? MUSE Hot Topics Summit
Date: November 12 - 13, 2013
Location: Island Hotel Newport Beach, California
Attend this sizzling Summit and learn about the hottest issues in healthcare IT: Upgrading to MEDITECH 5.66 Converting to ICD -10 Implementing Patient Portals Completing your CPOE Project Attesting for Meaningful Use Stage 2
You can register and learn more here:
http://www.museweb.org/muse_event_newport_beach_ca.
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Bridging the Gap from Disaster to Recovery By Jim Beagle,
President and CEO, BridgeHead Software
Introduction Healthcare organizations increasingly rely on data and applications for a dizzying number of tasks, from populating EHR databases to storing radiology images. Beneath it all, data is what makes critical patient files storable, retrievable, and searchable when needed most. However, disasters large and small continue to occur that thwart the best efforts of institutions to store, protect and share patient information. In the event of a system outage, response must be swift, enacted confidently and without delay so that the business of patient care can continue with minimal disruption. But as the recent events of Hurricanes Sandy and Irene show, some hospitals remain unprepared for disasters that can wipe out vital repositories of patient data. In fact, even relatively small failures such as data corruption can prove disastrous when appropriate protection and recovery procedures are not in place within these environments.
A new frontier for healthcare IT As healthcare providers increasingly come to rely on computerized systems in the course of caring for patients, healthcare IT is under more pressure to protect, retain, and ensure constant availability of this vast amount of medical data. The adoption and expanded use of Electronic Health Records (EHR) increases daily and federal support for programs to improve the quality of patient care will continue to drive the exponential growth of digital data within
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Bridging the Gap from Disaster to Recovery
the healthcare environment. For example, the HIPAA HITECH Act provides financial incentives for hospitals to quickly adopt EHR technology and inflicts financial penalties for those who don’t. With such forces at work, systems that were once a luxury at many healthcare facilities have quickly become essential to surviving in the current regulatory environment. The proliferation of medical data worldwide and its astounding rate of growth has resulted in backup and disaster recovery becoming a top priority for healthcare IT. As providers become ever more reliant on their systems in the course of diagnosing and treating patients, it becomes critical that data is readily available. Even one hour of downtime for a hospital’s EHR could negatively impact patient care – and extended outages have had even more severe effects. In such cases, what are healthcare providers to do? The old recourse was to “go back to paper.” But, as hospitals rapidly adopt all-digital models, paper-based records have become obsolete. Today, a typical community hospital in the United States may have dozens of TBs of electronic data, depending upon when and how aggressively they adopted digital systems. With this volume of data, it becomes economically and physically impossible to back it up on a daily basis. So how do hospitals protect this vital business asset? In an era when storage and protection is vital to providing adequate patient care, many organizations are taking a closer look at their plan for protecting data from disaster. It is important to remember that only by understanding the nature of the data can healthcare IT professionals devise a comprehensive approach to healthcare disaster recovery.
Why healthcare data is different Like any other business, a healthcare organization uses many different software applications to run its day-to-day activities. However, unlike other businesses, most of these systems directly or indirectly impact patients – any unex-
pected downtime in critical applications may jeopardize patient care. Healthcare IT is charged with keeping these systems available 24/7 and, in the event of an outage, is tasked with restoring operational capacity as quickly as possible. In the event of a large-scale disaster, the entire hospital must execute its business continuity plan to ensure minimal disruption to patient care. Healthcare IT plays its part by executing the disaster recovery plan perfectly to ensure that these systems continue to function in all conditions. While the stakes may be higher for healthcare IT, are the data protection and disaster recovery requirements fundamentally different than those of any other business? In many ways they are not, but in one key area they are: Healthcare organizations generate a large percentage of static data, the nature of which requires a particular approach to healthcare disaster recovery. For vast amounts of unchanging, unstructured or semi-structured data, archiving is a better approach than backup for protection purposes. By creating a few geographically dispersed copies of the data on multiple media types, hospitals are best positioned to meet Recovery Point Objectives (RPO) and Recovery Time Objectives (RTO) for hospital systems. For example, in the event of a disaster, a PACS database which is archived can be recovered as quickly as the Health Information System (HIS) and Radiology Information System (RIS), and then pointed at a secondary copy of the image archive, preferably extant on storage in a secondary data center. This combination of backup and archiving enables an optimal strategy for protecting all types of data in a hospital. By understanding the nature of the data found in clinical systems, healthcare IT can deliver both realistic and acceptable RPOs and RTOs to the business-side interests of healthcare institutions. In the event of a disaster, the organization can rest assured that mission-critical applications will be available when needed. And doctors and nurses can get on with the business of patient care rather than distracting themselves with the business of healthcare IT. SPRING 2013
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Bridging the Gap from Disaster to Recovery
Real world disasters: it can happen anywhere, any time Unfortunately, even with all that is known about the importance of maintaining a robust data recovery and protection plan, many hospitals still encounter scenarios that put patient data in harm’s way. The most common root causes of failure are data corruption and user error, and during the recovery phase, almost all hospitals discover that there is an application or set of applications that they haven’t been sufficiently protecting.
It’s critical to define decision-making responsibilities in advance of disaster. Case Study 1: flooded hospital data center At one critical access hospital, a significant weather event rendered several departments uninhabitable. The hospital closed immediately, and data recovery wasn’t even attempted for three days. The data center was flooded, and hospital staff could not reach equipment for some time due to police activity and general disorder. Once hospital IT staff finally reached the data center, they discovered that untrained staff had removed the servers but left the SAN storage underwater – with the hospital’s backup tapes in a cardboard box next to it. Data on SAN storage and tapes remained underwater, and there was no storage hardware available to support restore when staff finally could begin the process. A rented space was used for recovery, and data was backed up from SAN following a lengthy drying process in order to make it available for recovery onto the new systems. This was a critical problem in part because, in order to fulfill payroll, the vast majority of MEDITECH servers in this hospital needed to be restored due to the dependencies
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between modules. It was over six months before the hospital saw another patient due to physical infrastructure issues. Eventually, the hospital merged with a regional organization.
Case Study 2: data corruption impact At a large hospital chain, the MEDITECH EMR disk slowly corrupted over several months yet went undetected because the corruption was not significant enough to disrupt the EMR. Backups to tape continued to occur on a daily basis, dutifully backing up the corruption. As corruption progressed, the hospital’s server became slower and slower, prompting staff to reboot the server, only to discover it was no longer operational. When the previous night’s backup was restored, it contained the corruption and would also not boot. Although the hospital had replicated MEDITECH data using array replication technology, the replicated copy was corrupted as well, rendering the failsafe useless. Eventually, the health IT team found a good, months-old backup with no corruption; however, they were faced with a difficult decision: to restore from a known “good” backup that was months old and lose significant portions of EMR data, or wait for a solution to resolve the corruption? The hospital elected to try and fix the corruption, and consultants were able to “transplant” the Master File Table (MFT) from the good, restored disk to the corrupted disk, and the solution worked. The hospital was able to recover back to the time of the reboot, but still had to re-enter and fix data. The net downtime for the EMR was over 36 hours.
Lessons Learned So, what are the lessons learned? It’s extremely important to keep many generations of backups, and to combine archive and backup to ensure protection with appropriate RPO and RTO for all types of hospital data. The vast majority of MEDITECH restores come
Bridging the Gap from Disaster to Recovery
from monthly (or yearly) tapes. Array-based replication is useful tool, but it does not eliminate the need to keep many generations of backups, particularly offsite. Any hospitals using array-based replication in MEDITECH should be certain they are achieving application consistent points in time. Adding archive to backup can improve protection by reducing the amount of data in the backup pool, shortening recovery as well as backup windows. It’s critical to define decision-making responsibilities in advance of disaster. Hospitals need to determine who is responsible for making the decision to keep a system down in order to get back to a better point in time. More importantly, who in the organization would determine if losing several months of data in order to get back up and running sooner is a worthwhile decision? Test recovery on a regular basis to ensure that all critical data are protected and recoverable. Disasters are by nature unpredictable. A SAN can fail due to a bad firmware upgrade, or a sprinkler system could self-activate due to high heat, flooding servers and storage systems. Disasters take many forms, and evidence grows daily supporting the investment in a comprehensive data protection and backup strategy.
Organizations should keep a basic checklist in mind for achieving these goals:
• Establish realistic RPOs and RTOs for all applications; • Maintain geographically dispersed protection with multiple sites and multiple formats; • Plan for deep generational protection (monthly and yearly backups); • Ensure consistent backups are performed on all MEDITECH applications (ISB, IDR, MBF); • Ensure PACS/DICOM have both geographical and generational protection; • If data is stored at multiple sites, ensure resources are in place to backup secondary datacenter; • Establish and circulate a documented plan for disaster recovery; • Ensure staff is well-trained and knowledgeable in hospital’s preferred backup product; • Know who in the organization can make critical decisions involving data loss and recovery in the event of a disaster.
Best practices checklist By now it should be clear why disaster recovery continues to be a top concern for healthcare IT professionals. The proliferation of computerized clinical systems and the rapid adoption and reliance upon them by healthcare professionals mandates that healthcare IT ensures constant availability. In the event of a system outage, a plan must be in place to recover quickly and efficiently, prioritized by the importance of each system as it relates to the business of the hospital. Organizations should keep a basic checklist in mind for achieving these goals:
The protection and recovery of hospital systems is somewhat complicated by the static nature of the majority of healthcare data – clinical images and scanned documents that rarely change once created and that consume vast quantities of disk storage. In order to optimize efficiencies, healthcare IT must protect this data in a way that meets the availability requirements of the organization while containing costs. A strategic combination of backup and archiving technologies is the best method to ensure that all data types within a healthcare organization are adequately and cost-effectively protected.
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EXECUTIVE INSTITUTE S A N
D I E G O , C A
CIO (Can’t Implement On-time) Join us in sunny California for the MUSE Executive Institute to ensure that’s never you! Dates: Venue:
January 19-21, 2014 Coronado Island Marriott Resort & Spa, San Diego, California
Featuring: Ed Ricks, VP of Information Services/CIO, Beaufort Memorial Hospital, Beaufort, South Carolina Rena Salamacha, CIO, Mee Memorial Hospital, King City, California Cathy Crowley, CIO, Columbia Memorial Hospital, Hudson, New York Ken Kupetsky, VP/CIO, St. Mary’s Healthcare System for Children, Bayside, New York Anne Marie Herrera, Strategy and Business Development, Vice President, maxIT-VCS, an SAIC company
Presentation Topics:
• Meaningful Use Audits • Rural Healthcare – Successes and Challenges in Implementing an EMR • Strategy Management, Alignment and Execution
Event Highlights:
• Unique Reverse Tradeshow Experience • Stunning Location
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• Unparalleled Networking Encounters • Free Travel and Accommodations
more about the MUSE Executive Institute: www.museweb.org/2013_executive_institute_san_diego.
MUSE INTERNATIONAL
Have you registered for an Online Peer Group JAM Session? More than 900 of your colleagues have! Sometimes searching for an answer can be like searching for a needle in a haystack. But MUSE is helping you locate the answers you need by bringing together the right people. The online Peer Group JAM sessions focus on specific modules and topics in an informal, dialogue-rich setting. Patti Bolduc attended a recent session and was energized by the interaction: “I found invaluable information from the MUSE Peer Group JAM session I attended, which was BMV/eMAR. This session occurred just before my meeting to give an update on our BMV project and I was able to share my new-found information with our team. I have already registered for many other JAM sessions and look forward to participating; thank you for offering these opportunities!� Patricia Bolduc
Clinical Systems Analyst, Information Technology, Eastern Connecticut Health Network
Watch for announcements and check the MUSE website for Peer Group JAM session updates. Thank you to the generous sponsor Dell Services! SPRING 2013
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MUSE
is pleased to introduce webinar subscriptions
You asked for a way to simplify the process, and MUSE heard you. MUSE Webinars are now available as a subscription. You can save time and money by completing the purchase process one time.
How it works
Purchase a webinar subscription and you and your entire team will have year-round access to webinars for 12 months. These sessions are typically one-hour in length and sold separately for $100 each.
Access for all your staff
Your subscription gives you an access code unique to your facility that provides waived registration to any webinar of your choice.
Purchase your subscription You can find upcoming webinars and watch for new postings on the MUSE Website.
FAQs Q
Do I receive one access code for the entire facility subscription? Yes, you will receive one access code for your facility. Upon purchase of the webinar subscription, your facility's subscription administrator (the individual who registers for the webinar subscription) will be emailed the access code. This is the code that will be used to register for all webinars for 12 months.
A
Q
How do I share the access code with my co-workers? The facility administrator (the person who purchases the subscription) is responsible for distributing the code within the organization. The best way to share the access code is to forward the confirmation email that you receive from MUSE to the people who you want to have access to your subscription.
A
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Q
Does each person who wants to attend a webinar at my facility need to register separately? A Yes, each person who wishes to attend a webinar needs to register separately, unless your facility is planning
to attend the webinar as a group using one connection. This is because each webinar has limited space, so MUSE needs to have an accurate count of connections for each webinar. Q
How do I register for webinars using my access code? A
When you see a webinar that you'd like to attend, select the registration link and enter the information as you are prompted. You will enter your access code into the coupon code field to bypass the payment details. Once you have completed the registration, click submit. Your confirmation email will be sent with your webinar details.
Q
When will I receive the login information for the webinars I wish to attend? A
Your login information and connection link are included in the confirmation email you receive from MUSE when you register for the webinar. Additionally, MUSE emails you a reminder that includes your link one day before the webinar.
Q
I have a different question. Who can I speak with about the webinar subscriptions? A
Please contact Alica Roberts MUSE Director of Education and Marketing: education@museweb.org or
phone 877.491.4703 ext.7
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muse web .org
On-going MUSE Events
Mark your Calendars for Upcoming MUSE Events! September 13, 2013 Rapid City Regional Hospital Rapid City, South Dakota
Hot Topics Event Island Hotel, Newport Beach, California
September 19, 2013
January 19 – 21, 2014
Holland Bloorview Kids Rehabilitation Hospital Toronto, Ontario
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November 12 – 13, 2013
SPRING 2013
MUSE INTERNATIONAL
MUSE Executive Institute Coronado Island Marriott Resort & Spa, San Diego, California
Clinical
Consulting
First Databank
Dell Services
Health IT
Interface
The Shams Group (TSG)
Computer Credit, Inc.
120 Royal Street Canton MA 02021 www.dell.com/meditechsolutions Corrine Cutler Tel: 781-401-2104 corrine_cutler@dell.com
701 Gateway Blvd Suite 600 South San Francisco CA 94080 www.fdbheath.com Pam Quinlan Tel: 650-588-5454 ext. 867 pquinlan@fdbhealth.com
1304 West Walnut Hill Lane Suite 240 Irving TX 75038 www.shamsgroup.com Sales Department Tel: 469-586-3317 info@shamsgroup.com
P.O. Box 5238 Winston-Salem NC 27113 www.cciletterscollect.com Denise Stroup Tel: 336-761-1538 dstroup@cciws.com
Have Your Company Listed Contact the MUSE Director of Education and Marketing Tel: 877 491 4703 ext.7
Email: alicia@museweb.org
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