March 31, 2011
Posted by: Tara Marchi
MEDITECH has put their stake in the ground with over eight years of research and development behind their 6.0 platform. For those newer to the 6.0 platform it promises streamlined clinical and business workflows via role-based desktop configuration which allows organizations the ability to deliver better patient care by increasing access to critical information across many venues. The newer technology allows for higher availability, better access over the internet and ensures your multi-disciplinary teams are working in closer tandem then ever before.
Gone are the days of department centric workflow, paper reliance and information system short comings. The MEDITECH 6.0 technology will bring your organization through the Clinical Transformation process. Have I got your attention? The buzz is certainly out there in the MEDITECH community and organizations are asking the question, “How can I ensure my organization is ready?”
Fast forward through the contract negotiation process and picture that your organization is now in the implementation queue ready to migrate to MEDITECH 6.0; you’ve mapped out your hardware and infrastructure needs, set up your core team and potentially hired additional consulting resources to get the job done. You have begun your application planning and proposed changes to ensure your organization provides the highest standard of patient care and you are confident that you will reap the benefits of moving to the new MEDITECH 6.0 platform. After all this planning centered on applications, hardware and infrastructure, you are probably thinking - “What’s left to consider?”
One of the biggest considerations that must take place early in the planning process is the evaluation of your current integration state. Even the most MEDITECH centric organizations are currently interfacing with multiple 3rd party ancillary systems or point of care technology. This is the most opportune time to evaluate your current landscape for both your standard HL7 interfaces as well as any custom interfaces that may be in place. This could include interfaces designed by MEDITECH or 3rd party vendors. While you are at it, now is a good time to take inventory of your scripted workflows and interfaces as well. One must consider the importance of this integration and data sharing as it impacts productivity of your end users and ultimately your patients’ safety as that too depends on these connections. Without a doubt as you implement MEDITECH 6.0 there will be an expectation from your end users in other departments such as OR and ED to integrate their respective devices to the core HIS. As you continue to implement these advanced clinical systems you will be asked for sophisticated integration connections to complex devices such as bio medical and smart pumps. Are you beginning to realize the changes to your interface topography?
If you review the posted MEDITECH 6.0 workplan and converted 6.0 clients, a forward facing topic is integration analysis and strategy. As you embark on this amazing transformation you must ask the following questions:
- What’s the state of our interfaces? Should we conduct an audit and map them out? Are there any cost savings to be found?
- Do we have the staff bandwidth and competency levels to manage interface migration?
- What will my migration plan be for our interfaces? Will all current interfaces be necessary in 6.0? Do I need to purchase or develop new interfaces for our Migration to 6.0? How will I map out the timing, sequence and hardware needs?
- If Advanced Clinicals will be an added addition to our implementation, what integration strategies must take place to ensure our staff has access to the most accurate real-time information?
- What if direct interface connectivity isn’t an option (HL7/XML feeds)? How can I leverage technology to integrate all systems?
These are just a few questions that come to mind but hang in there because there are proven solutions and evidence based roadmaps out there to help you along the way.
Let’s take a look first at current state. If you mapped out on paper a diagram of your current interfaces would it look like a spaghetti diagram? Do you have more point to point interfaces than you expected? How many times can you send ADT information outbound from MEDITECH? Do you count ten, fifteen or fifty ADT feeds currently being managed? Now is the best time to consider how to maximize your current investment and determine how standard interfaces can be leveraged which will provide immediate cost savings. Should you consider moving from a point to point strategy to an interface engine? Don’t forget when implementing Advanced Clinicals your need for an integration strategy grows exponentially.
The question now becomes centered on interface & integration migration. As part of the resource planning your organization must review current allocated FTE’s and access the internal bandwidth to handle the interface migration, timing, testing and go live support. Your organization should review if interface standards have changed from one platform to the next, meaning was it custom in Magic and will it correctly repoint in 6.0? What time allocation is necessary to work with the 3rd party vendors to seamlessly migrate?
One must consider options such as outsourcing, where industry experts handle the interface/integration maintenance or hiring additional staff to support this task. It’s important to ensure the migration of your interfaces and integration is seamless not only for the happiness of your staff but patient care and data integrity depend on it.
Lastly, let’s look at future state. Where in your implementation plan does Advanced Clinicals fit? Oh and by the way… advanced clinicals are no longer defined by the nursing units electronically documenting and bar-coding medications, advanced clinicals are departments such as OR, ED, and Cardiology. These departments will depend on connectivity to complex technology and the move toward a comprehensive Medical Record will require this integration. This integration includes interfacing multiple patient monitor systems such as PACS Systems, Cardiology PACS Systems, Smart Pumps, OR Anesthesia systems and ED Monitoring systems back to the MEDITECH HIS.
Can you imagine what your point to point interface diagram will look like with these additional departments now interfacing? If your hospital is like all others you are working with multiple third party vendors, with different interface specifications and capabilities, imagine the management around this. As the clinical transformation is taking place patient safety depends on real-time, accurate data to be delivered to all care givers. Interfaces can’t go down, it just becomes unacceptable.
When migrating to 6.0, now is the time to map and build a tactical and strategic integration strategy to ensure you have the right technology and proper levels of staff in place while adhering to your 6.0 project budget. As your organization looks to make this commitment to achieve clinical transformation and deliver the highest patient care with 6.0, evaluating your integration strategy should be at the forefront, rather than an after thought. By making this a priority early on, your staff will be able to focus on the application aspects of building and maintaining the MEDITECH 6.0 system. The results will be a new system designed and implemented to improve patient safety, achieve end-user acceptance, with guaranteed cost savings along the way.
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