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muse international Winter 2011
- Norman Regional Health System Hosts BMV and CPOE Event
- MUSE Members Visit Spokane for Inland Northwest Health System Event
- Have you Attended a Webcast Yet?
Ask me about CPOE, a Physician’s Story
The Ascent:It can be Accomplished …
Henry Mayo Newhall Memorial Hospital’sACS Implementation
The Ascent:It can be Accomplished …
Henry Mayo Newhall Memorial Hospital’sACS Implementation
Play MUSE Clues
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H O S P I T A L
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H O S P I T A L
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©2010 First D
ataBank, Inc. A subsidiary of H
earst Corporation.
CLUESCLUES
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MUSE Conference Higlights MUSE Spokane 17
2011 Nashville Conference Preview 19
MUSE Webcast 21
INSIDE
FEATURES
Winter 2011 VOLUME 3 NUMBER 1
Departments
A Letter from the Chair 6
by Terry Mouland
From the Desk of the CEO 7
by Alan Sherbinin
MUSE Clues Game 18
Commercial Member Directory 28
Articles
The Ascent: It can be Accomplished... 9
Henry Mayo Newhall Memorial
Hospital’s ACS Implementation
by Dr. Bud Lawrence
Norman Regional Health System 13
Hosts BMV & CPOE Event
Ask Me about CPOE, A Physician’s 23
Story
by Dr. Besson
A Touch of Class... A New Paradigm 26
in Clinical Computing
by Kam Shams
WINTER 2011 MUSE INTERNATIONAL 4
On the COVER - The Ascent: It can be Accomplished...Henry Mayo Newhall Memorial Hospital’s ACS Implementation- “I think at first most facilities may look at this (implementation) as a barrier, but it really facilitates good, safe medical practice. ”
39
page 26 - A Touch of Class... A NewParadigm in Clinical Computing- “The world of clinical computing is at the beginning of a new
paradigm where a ‘touch’ will be at the core of ‘Meaningful Use.”
page 23 - Ask me about CPOE,a Physician’s Story- “We all have something to offer and we are ready to listen.”
page 13 - Norman Regional HealthSystem Hosts BMV & CPOE Event- “very informative with great interaction between attendees and presenters.”
9page
MUSE is committed to assisting the MUSE Membership in identifying products
and services that compliment and supplement their healthcare
information systems.
The MUSE Matters Magazine is published four times a year, along with one Conference Program. Published by the MUSE Board, the Magazine is internationally distributed to all MUSE members. All rights reserved; reproduction in whole or in part without written permission is strictly prohibited. Copyright 2003 by Medical Users Software Exchange.Editorial contributions are welcome, but Editors request that contributors query first. Please supply all contributions in text format accompanied by photos, captions and photo credits. MUSE reserves the right to use materials at its discreation and reserves the right to edit material to meet MUSE requirements. Contributor’s act of mailing contributions shall constitue express warranty that the material is original and no infringement on therights of others.
Any questions or comments should be directed to:
Jenni IsfanCommercial Member ManagerPh 877 491 4703 ext.2Email [email protected]
US Mailing AddressMUSE International#173 - 816 W Francis AvenueSpokane WA 99205
Canadian and International Mailing AddressMUSE International#101 - 1865 Dilworth Dr. Suite 350Kelowna BC V1Y 9T1
PublisherMUSE Board
Editor in ChiefAlan SherbininMUSE CEO
Commercial Member ManagerJenni Isfan
Winter 2011 Volume 3 Number 1Be Sure To Book Your Ad Space
NOW!DONʼT WAIT..Book early to ensure yourpreferred ad
space in MUSE Matters
Managing EditorAlicia Roberts
MEDITECH was introduced to the hospitals in
Newfoundland (where I am from) and Labrador
in the early 1980’s to support financial, admin-
istrative and clinical applications. From an I.T.
perspective, MEDITECH was the main system
supported. While the system was challenging
and there were many expectations, in most
organizations all I.T. staff knew the system and
could provide support to the various MEDI-
TECH modules. The network, storage and
server requirements were clearly identified by
MEDITECH and installation was fairly straight
forward.
Fast forward to 2011 and we see a very different
healthcare environment. In Canada there
continues to be a move to regionalization
resulting in very large organizations. For
example, the hospital I worked at in the early
1980’s had about 2,000 employees and five I.T.
staff. Today that hospital is part of a regional
authority with more than 13,000 employees
and 110 I.T. staff. In the U.S. large organizations
have developed from mergers and acquisitions.
While MEDITECH is still a dominant player in
our organizations, it is now part of a very com-
plex I.T. environment consisting of numerous
applications from MEDITECH and other
vendors as well as tight integration with many
medical devices. Diagnostic Imaging, Laboratory,
Cardiology and others are all implementing digital
solutions that integrate with the information tech-
nology environment for networking, storage and
electronic records management. When you add
Provincial, State and National initiatives such as
‘Meaningful Use’ to the mix, the end result is a very
complex and busy environment.
If there ever was a time that we needed to be
networking with our colleagues it is now. The old
expression “why reinvent the wheel?” is very relevant
to our environment. Where possible we need to
leverage the efforts of others and share what we are
doing with them. Through this networking and sharing
organizations are able to be more efficient resulting
in better utilization of resources.
The many offerings by MUSE give us the opportunity
to network and share solutions. The MUSE Interna-
tional Conference May 31st to June 3rd in Nashville is
another great opportunity for us to network and
share our successes and challenges. I look forward to
meeting many of you in Nashville, and I am sure that
my organization will benefit from what I will learn
and discover at the event.
Terry Mouland
Terry MoulandDirector Information
Management & TechnologyEastern Health
Waterford Bridge RdSt. John's NF A1E 4J8
Tel: [email protected]
A LETTER FROM THE CHAIR
WINTER 2011 MUSE INTERNATIONAL 6
How things have changed …
Alan SherbininMUSE CEO
Toll Free 1 877 491 4703Ph 250 491 4703Fx 250 491 4773
Email [email protected] www.museweb.org
US Mailing AddressMUSE International
#173-816 W Francis AvenueSpokane WA 99205
Canadian and InternationalMailing Adress
MUSE International101-18655 Dilworth Dr
Suite #350Kelowna BC Canada V1Y 9T1
FROM THE DESK OF THE CEO...
7 WINTER 2011 MUSE INTERNATIONAL
Is it a happy new year?Perhaps not if we’re one yearcloser to the end of the world.
As I flip the calendar, I recall that the astute Mayans ended their calendar
in 2012 (which is odd since they clearly had too much time on their
hands). While some believe that humans will undergo a positive physical
or spiritual transformation in 2012, others think that we will be doomed
by some cataclysmic, calamitous catastrophe. I wish there was better
information so I would know what to pack.
Regardless, a new year’s day always brings some feeling of rejuvenation.
Out with the old; in with the new. What we need are more such days. So
besides our January 1 celebrations on the Gregorian calendar, add these
dates to your calendar to enjoy more opportunities for revitalization:
January 14 – Marks the New Year for the Eastern Orthodox Church
and those using the Julian calendar. Many spend the day reflecting on
the previous year and think about meaningful resolutions for the New
Year.
February 3 – The New Year on Chinese Lunar calendar begins. 2011
is the year of the rabbit, so hop to it. It is tradition that every family thor-
oughly cleans the house to sweep away any ill-fortune in hopes to make
way for good incoming luck.
March 5 – On the Tibetan New Year’s Day, people arise early to place
water and offerings on their household shrines.
WINTER 2011 MUSE INTERNATIONAL 8
March 5 – The Balinese New Year is a day
of silence, fasting, and meditation.
March 14 – The first day on the Sikh
Nanakshahi calendar is celebrated with wor-
ship and festivities such as parades.
March 20 – People mark the Persian New
Year with a major spring-cleaning of their
houses, and buying new clothes and flowers.
April 1 – The Assyrian New Year celebra-
tions involve parades and parties. Some Assyr-
ians wear traditional costume and dance in
parks for hours.
April 4 – The Telugu New Year is celebrated
with great fanfare and gatherings of one’s
extended family to enjoy a sumptuous feast.
April 14 – Celebrate the Thai New Year by
gently pouring a small amount of water on
someone’s hands or over their shoulder as a
sign of respect. The water is meant as a
symbol of washing away badness.
May 31 – Enjoy the pre-conference day for
the 2011 International MUSE Conference.
Often called “MUSE Conference Eve”, the
festivities include workshops, Site Visits, and a
CIO Executive Institute. Attendees celebrate
networking, education, and training.
June 1 – Marks the main day of the 2011
International MUSE Conference. The tradi-
tional celebration continues through to June
3. Participants marvel at the array of educa-
tional opportunities, the value of meeting
peers, and the appealing feelings of enlight-
enment and happiness. Many people attend
the jubilee annually to become cultured,
re-energized, and just plain smarter.
Happy New Year.
Alan SherbininMUSE CEO
Henry Mayo Newhall Memorial Hospital,
located in Valencia, California, successfully
implemented its Emergency Department
Module (EDM) in seven months, going live in
September 2010. The Patient Care System (PCS)
and Physician Care Management (PCM)
go-lives followed, both in November 2010.
When Dr. Bud Lawrence, emergency depart-
ment physician, first embraced his role as
Physician Champion and began working to
implement the hospital’s Advanced Clinical
System (ACS), he recognized the challenges
of the project at hand. “It was intimidating at
the onset because so many physicians and
healthcare staff were used to the standard of
paper, and couldn’t understand how it could
be any better electronically,” he said. He dealt
with questions like, “How will this benefit us?”
“Is it just to be compliant with government?”
“Retrospectively, though, it’s obvious physi-
cians now really grasp this,” he said.
“I think at first most facilities may look at this
(implementation) as a barrier, but it really
facilitates good, safe medical practice. It’s
efficient, essentially taking out the middle
man,” he explained.
9 WINTER 2011 MUSE INTERNATIONAL
The Ascent It can be accomplished…
Building the SystemThe ACS project at Henry Mayo Newhall Memorial
Hospital was launched in January 2010, with an
expected go-live of the EDM Phase 1 in September
2010 and Phase 2 in August 2011. “You have to begin
with efficiency in mind; we thought, let’s create CPOE
where everything is efficiency-based, as intuitive as
possible and easy to navigate. From our perspective at
our facility, we’re somewhat of an outlier. We put a lot
of spontaneity into development, not following a rigid
process, but instead doing what we needed to do
along the way to accommodate our needs. We
brought in an entire EDM (Phase 1 and 2) and it
should’ve taken more like 18 months or two years, but
it took seven months,” Lawrence said.
All along nursing documentation was being renovated
as well. “We originally signed on with MEDITECH for a
staged approach with Emergency Department
Module (EDM) and Patient Care System (PCS), but we
actually built both simultaneously,” said Adnan Hamid,
IT Director. “When Dr. Lawrence got involved, he really
persuaded us to work harder and see the importance
of what we were doing. While doing both at the same
time was very hectic, it also met mutual needs at the
facility – IT, nursing, pharmacy and so on, instead of just
one focus,” he stated.
The implementation team itself was comprised of
people from various areas of specialty, who all worked
together toward the goal. “We had a really wonderful
implementation team that was a dynamo of activity,”
Lawrence said. Hamid agreed and further explained,
“During our execution we continued to harness enthu-
siasm and energy that we built during the process and
channeled them in to the result.”
Dr. Lawrence garnered an approach that required
more effort and foresight during the build process. “A
project like this – the more energy and time you
contribute on the front end will save you on the back
end,” he said. “We did not want to be redoing things
when we realized what didn’t work, so we trialed a lot and
thought every scenario through for the best outcome.
For example, for physicians it’s horribly inefficient to
enter orders individually, so we created order sets; more
than 90 separate order sets are now used daily. It’s not
wasted time to do this on the front end,” Lawrence said.
“Our physicians in the ER are now 100 percent
efficiency-positive, which means they are actually
working faster importing orders without a unit secre-
tary. They are also able to sign off instantaneously on
reports, rather than having them transcribed. We’ve
gone from dictating and transcription to voice recogni-
tion (we have around 500 voice recognition templates),
which is so much more accurate, time-effective and
efficient,” he said.
Why it is SuccessfulDr. Lawrence and Mr. Hamid believe several compo-
nents were essential for their success.
A self-professed proponent of physician buy-in, Dr.
Lawrence believes it is critical to provide not just a
good product, but the best you can offer so that every-
one will want to use it. One key to the success was the
promoted system ownership throughout the build and
implementation. “By accepting ownership of the
system – we’re going to make sure people use it,” Law-
rence elaborated. “You’re taking an area where some
physicians have been comfortable for years – it’s a
huge deal, and one that can be met with resistance. But,
we did little things to promote satisfaction, like providing
physician comment boxes. I checked these often and
made changes immediately; it made a huge difference
in satisfaction,” he explained.
“We had a reallywonderfulimplementationteam that was a dynamo of activity,”
WINTER 2011 MUSE INTERNATIONAL 10
Henry Mayo Newhall Memorial Hospital is a 227-
bed not-for-profit acute care hospital serving the
Santa Clarita Valley since 1975. Services include
trauma, emergency, intensive care, maternity,
surgery, nursing, wound care, behavioral health,
and acute rehab, as well as cancer, cardiology,
imaging, lab, digestive, respiratory services and
physical and occupational therapies. Henry Mayo
Newhall Memorial Hospital is located at 23845
McBean Parkway, Valencia, CA 91355-2083. For
more information, visit www.henrymayo.com or
call (661) 253-8000.
11 WINTER 2011 MUSE INTERNATIONAL
About Henry Mayo
The team lead is also extremely important to the
implementation. “You must have a competent, enthu-
siastic lead who will commit time and dedication to
the project,” explained Lawrence. “This person has to
be available for the team,” he continued. Hamid elabo-
rated on the importance of a dedicated physician
champion. “Dr. Lawrence bolstered team morale and
was basically there 24-7. You have to have a Dr. Law-
rence at your facility!” he said.
Another aspect that is crucial for the project is that the
individuals congeal as a team. “This group is comprised
of nursing, IT, tech, pharmacy and physicians, so every-
one is looking at it from a different angle,” Hamid said.
“Frustrations do happen, but they have to be kept to a
minimum so everyone can work together effectively,”
he said.
“Finally, the CIO has to be supportive,” Lawrence said.
“You need someone who will accommodate the needs
during the project and utilize resources up front so you
don’t play catch-up. For example, if you realize that you
need faster computers, they should be obtained
during the build process, not later once you’re up and
running,” he said.
“After go-live you can’t stop, though,” Lawrence said.
“You continue to be a proponent – stay on top of any
issues, because when the dust settles, things will arise.
Being prepared to meet new and unexpected chal-
lenges ensures future success, too.”
For Henry Mayo Newhall Memorial Hospital, the next
step is to go-live with Computerized Physician Order
Entry and physician documentation in the in-patient
areas. “Our success is not only in the ED, but on a
grander scale,” Hamid said. “When we start with
in-patient areas, we can just apply the recipe for
success; rewards are still out there to be won,” he said.
“Ultimately this is all about the people and providing
better patient care,” Lawrence concluded.
Keys for implementation:
•Promoted system ownership for users
•Committed project lead
•Positive implementation team dynamics
•Flexibility and foresight during build
•Supportive CIO
©20
10 B
eaco
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artn
ers,
Inc.
Make us your partner every step of the way.
MEDITECH 6.0 readiness, planning,
implementation,optimization…
Beacon Partners can help you successfully navigate the signi� cant challenges of a MEDITECH 6.0 migration. We are a MEDITECH-approved advanced clinicals consulting vendor who understands your patient care strategy. We have helped many MEDITECH customers throughout North America work through the same challenges you will face. No one knows healthcare, or MEDITECH, better than Beacon Partners. For access to the latest thinking on this and other healthcare topics, visit www.BeaconPartners.com today. 1-800-4BEACON x7419
Norman Regional Health System, located in Norman, Oklahoma,
graciously hosted 76 MUSE members October 28-29 to learn
about its recent eMAR and BMV implementation, as well as its
brand new CPOE project. The event was opened by John Meharg,
Director HIT, who welcomed attendees and provided an event
summary. He introduced David Whitaker, the CEO of Norman
Regional, who discussed the importance of BMV and CPOE to the
Health System Board and Executive Management and how this
degree of importance is communicated to all levels within the
health system. He explained why these projects have a much
better chance of success, if it is fully supported by the Board and
Executive Management.
Next, nursing administration staff elaborated about the tremen-
dous process change for the nursing department, and why
support for the project has to be clearly communicated to the
staff for the project to be successful. The Director of Nursing
Informatics then discussed the structure of the installation, what
teams were needed, who the decision makers were and why the
installation must involve all the stakeholders to be successful.
Panelists from the pharmacy department described how BMV
affects them, what processes are impacted, what equipment is
needed, and what it really means to barcode your medications. This
session was interactive and included questions from the audience.
During the lunch break, attendees had an opportunity to visit
exhibitor displays and learn about related products and services.
Additionally, at each lunch table a representative from Norman
Regional Health System, who was familiar with the installation,
was available to answer questions.
Norman Regional Health SystemHosts MUSE Members foreMAR,BMVand CPOE Event
13 WINTER 2011 MUSE INTERNATIONAL
CLUESCLUES
WINTER 2011 MUSE INTERNATIONAL 14
The afternoon sessions included presentations
about other non-medication uses of BMV (such as
breast milk) and how BMV can present unique
challenges for non in-patient departments (day
surgery, PACU, etc.). A panel of experts discussed
some of the issues they faced in these areas and
how those were resolved.
The final presentation was an interactive session
led by a panel of bedside nurses, who discussed
their use of BMV, including the good, the not so
good, and the downright ugly of using the
system. Each nurse offered a short and informal
perspective from his or her standpoint, and the
panel answered questions from the audience.
Attendees then traveled to the Norman Regional
HealthPlex, a just-opened 152-bed, state-of-the-
art specialty hospital to see demonstrations of
BMV and tour the new facility.
The second day was kicked off by an exciting
presentation about CPOE. Brian Yeaman, M.D.
discussed the importance of CPOE relative to
patient safety and the financial implications of
doing, and not doing, CPOE, in the time of “Mean-
ingful Use.” Dr.Yeaman is a practicing family
medicine doctor and is the health system’s CMIO.
His presentation was followed by an eye-
opening look at how CPOE changes many
processes in nursing and pharmacy. This session
included both nursing and pharmacy staff and
highlighted the processes that must change, and
how those changes can be put into place. Order
sets were also discussed during this session.
The event was wrapped up with an engaging
presentation by Patricia Trumm, Manager in Mar-
keting for MEDITECH, Navigating Meaningful Use
and Beyond with MEDITECH. This session
provided an overview of ARRA's HITECH Mean-
ingful Use criteria and how attendees’ current
MEDITECH systems can help position their orga-
nizations for achieving their mean-ingful use
goals. Also discussed was how the advanced
clinicals systems continue to evolve to enhance
quality, safety & efficiency within health care
organizations.
Quotes from attendees:The event was …
“very informative with great interaction between
attendees and presenters.”
Harold Gottlieb, CMO, CHRISTUS Health
“great exposure to an unfamiliar process. The
blending of disciplines focused on the process as a
whole and not segmented or compartmentalized.”
Kathy Hawkins, RN Applications Analyst,
Stillwater Medical Center
“informative, well presented, and answered many
of the questions I have about converting to the
MEDITECH BMV product.”
Liz Michael, CNO, Stillwater Medical Center
“The event was informative, wellpresented, and answered many of thequestions I have about converting to
the MEDITECH BMV product.”
Liz Michael, CNO,Stillwater Medical Center
continue
Quotes from attendees (CONTINUE):The event was …
“worthwhile and very beneficial to me. It was great to have it in Oklahoma so that we could send more people to it and spend less money traveling. The Norman Regional Healthcare System had a great facility for hosting an event of this type and I hope will do this again.”
David Parker, Director, IT Department,Jackson County Memorial Hospital
“very informative and shared some go-live steps we will use to bring BMV on with less stress to our staff. We really appreciated how candid, humble and gracious the Norman leadership were at this event.”
Toni Robinette, Business Systems Analyst, Cook Children’s Health Care System
“very insightful for our team. Our facility is going live on BMV in Feb. 2011 and it was good to hear what worked and what didn't work during the Norman Regional go live. I also felt that we received some very good information on CPOE to help us as we move towards its implementation. I found it both beneficial and educational.”
Cindy Carreno, Clinical Coordinator, ICU, Stillwater Medical Center.
Overall comments and highlights from attendees:
•This really focused on the importance of and process of navigating to BMV and CPOE. Many of our nursing staff went. This was the first time many had seen MEDITECH used at a different facility. The feeling as they came away was "We are not alone.” It also gave them more confidence to see that BMV can be done. With the informal setting many of nursing staff were able to get questions and concerns addressed by people who had been there.
15 WINTER 2011 MUSE INTERNATIONAL
•Although we already have eMAR and BMV, there
was very good information about Norman's planning
and implementation.
•It was beneficial for everyone in attendance to be on
the same MEDITECH page, maybe not the same
version, but honesty in sharing obstacles and chal-
lenges with function/design were meaningful.
•Lessons learned were very valuable as our corpora-
tion was headed down some of the same roads.
•This event really allowed us to understand the
project preparation and highlighted the bumps in the
road to help prevent in our own project.
•Our facility is getting ready to implement BMV in
about three months so this was very helpful. It
allowed us to bring some staff nurses that were able
to ask questions and hear how the process worked. It
also allowed us to hear what worked and didn't work
for Norman Regional.
•The staff members were very dedicated to their jobs
and knew their information well. They were very
willing to share all their information.
•The facility was fantastic and all of the staff at
Norman Regional was very willing to help. I enjoyed
the presentation by MEDITECH on their direction for
meeting Meaningful Use.
•The interactive model was excellent. Asking questions
was advocated. It was better than just listening to a
presentation.
•The smaller group was conducive to a more "round
table" type atmosphere. This allowed more in-depth
pursuit of questions, answers, and ideas.
WINTER 2011 MUSE INTERNATIONAL 16
Norman RegionalHEALTH SYSTEM
•I was really impressed with the enthusiasm of
personnel at Norman Regional
•I especially appreciated how everyone from Norman
was so accommodating. I especially liked that during
the lunches they spread themselves out to all the
tables so we could ask questions.
•Facility is beautiful, functional, and very hospitable.
Non-conference associates were very aware, engaging
and hospitable to our group of attendees
•Schedule/agenda was tightly and respectfully main-
tained.
•Location, preparation, information shared...great
job, very well done.
•Excellent exchange between presenters and the user
group audience. Very open to questions and honest
discussion
•I really liked having everyone together in the same
sessions. This allowed IT, Pharmacy, Nursing and
physicians to hear more than their processes. We
forget sometimes how what we want can affect
another area and this allowed that picture to be
painted for everyone.
•Considering the time commitments that your care
providers had to put forth in addition to running their
respective areas of practice. The "Real Time" agenda
was very appropriate.
17 WINTER 2011 MUSE INTERNATIONAL
museweb.org
On-going MUSE Events
The two-day event was formatted into tracks so attendees
could choose sessions that best suited their needs; these tracks
included Advanced Clinical, Technology & Support, Administra-
tive and Site Visits. Various presentations were offered, such as
these highlights: Cloud Computing, The Security Landscape in
Healthcare, Improving Clinician Mobility and Productivity,
Paperless Hospital – Not Just the EMR Anymore, plus many
others.
The three hospital Site Visits took attendees to either Provi-
dence Sacred Heart Medical Center & Children’s Hospital, Provi-
dence Holy Family Hospital or the INHS Help Desk/Data Center.
The Providence Sacred Heart Medical Center & Children’s
Hospital tour demonstrated how providers are utilizing nursing
documentation and including in workflow processes to meet
these rapidly approaching deadlines. The Providence Holy
Family visit showed the inner-workings of the emergency
department and how they are utilizing HIT systems, including
CPOE, to provide efficient patient flow and care. The Data
Center tour demonstrated how the INHS Help Desk supports
more than 45,000 users - and how they maintain quality
customer service. While there, attendees saw a virtual tour of
the INHS Data Center.
Attendee feedback from MUSE Events provides a gauge of the
value in attending. This event received rave reviews, including
the following:
If Meaningful Use, technology and support topics were on your 2010 education ‘to-do’ list, this was the event for you! Inland Northwest Health Services (INHS), located in Spokane Washington, hosted 120 MUSE members October 5-6 for two days of Site Visits, presentations and networking.
• Each and every presenter was well versed in his or her material, and happy to speak with us after the presentations.
• Several speakers did a great job of keeping everyone's attention. There was a lot of useful information in a short amount of time. Everyone is so willing to help, share information and teach.
• Good opportunity to speak with peers at other sites.
• Well-organized. Location was great. Pertinent information.
Thank you to Inland Northwest Health Services for your generosity and hospital-
ity in hosting this MUSE Event!
Want to see presentations from the event? Power Point presentations are available for download on the MUSE website in the library section.
CLUESCLUES
“Want to play MUSE Clues? Simply locate the three clues
within the magazine, then email
the article or ad titles to:
by March 14, 2011.
A winner will be
chosen and sent
a $25 Amazon
gift card.
Sharon HorakDirector of Patient Accounts
Island Hospital, Anacortes, WA
is the winner of the FallMUSE Clues game!
WINTER 2011 MUSE INTERNATIONAL 18
19 WINTER 2011 MUSE INTERNATIONAL
Nashville 2011May 31, 2011 - June 3, 2011
The International MUSE Conference is just around the corner, May 31st - June 3rd, in Nashville, where Music City Becomes MUSE-ic City!
Expect networking with your peers, education, training and some fun, too.
Don’t miss the one-of-a-kind opportunity!
NASHVILLE, TENNESSEE
International MUSEConference
2011 May 31- June 3, 2011
MUSE-ic City
Centennial Medical Center Learn about the facility's nursing documentation tools - including demos of variety of tools for nursing documentation such as MEWS (early warning screen), vaccine assessment tool, VTE screening, chemo administration, clinical reminders, etc. www.centennialmedicalcenter.com
The year's conference is featuring Site Visits to some of Nashville's top hospitals:
Skyline Medical Center Learn about the facility's inpatient CPOE - including a general overview of the project and then discussions along three tracks: nursing impact, pharmacy impact, and physician impact. www.skylinemedicalcenter.com
Southern Hills Medical Center Learn about how the facility uses MEDITECH in the ED - including an overview of usage along two tracks: nursing documentation in EDM and BCMA, and CPOE in the ED. www.southernhills.com
Summit Medical Center Learn about the facility's throughput processes - including utilization of the system to address throughput including three tracks: Bed Management, OR, and Radiology.www.summitmedicalcenter.com
WINTER 2011 MUSE INTERNATIONAL 20
Are you Gleaning ALL the Benefits … of Your MUSE membership?
Throughout the past six years MUSE
has been offering webcasts as a
supplement to educational opportu-
nities for members. {Webcasts are a
web-based conference that includes a
presentation via the internet and
audio either through internet or
telephone}. This format is much more
economical than traditional meetings,
for obvious reasons, but it also allows
one to attend a session from the com-
fort of one’s own office, or conference
room. Additionally – some hospitals
broadcast MUSE webcasts using a
projector and speakerphone so many
can attend the presentation.
MUSE provides three webcasts per
month – on average- relating to topics
from NPR report writing to 6.0 imple-
mentation. These topics and present-
ers are recruited based on what the
need is for the MUSE membership.
Webcasts also feature participant and
presenter interaction through live Q&A
after the presentation and live Chat
during the session. These tools
enhance the webcast to bring the
‘networking’ feel to the virtual
environment.
If you have not participated in a MUSE
webcast, you are not fully benefitting
from your MUSE membership. Emails
are regularly sent announcing upcoming
webcasts, but you can check the
website: www.museweb.org, at
any time to learn about webcasts.
Also, if you are considering presenting
at a face-to-face meeting, consider a
webcast as a great outlet to practice
your presentation skills. Many
presenters thoroughly enjoy the
webcast format to hone their techniques.
Check out the upcoming webcasts.
For example, during the past several
months the following webcasts have
been presented:
• Intermediate Visual Basic for Applications• Clinical Documentation in EDM• Cultivating Physician Champions• Creating Graphs in NPR Reports• Project Management (series)• ARRA and Meaningful Use• Achieving the Seemingly Impossible Move to 6.0• Boldly Go Where no Canadian Hospital has Gone• Scanning and Archiving
All of these topics highlight pertinent,
relevant issues and themes impacting
healthcare professionals working
within the MEDITECH atmosphere.
21 WINTER 2011 MUSE INTERNATIONAL
museweb.org
On-going MUSE Events
On-going MUSE Events
on DEMAND
Attend a MUSE Webcast -When you Choose!Do you really want to attend a MUSE webcast, but just can’t coordinate
with the times offered? MUSE has recognized this challenge amongst the
membership and now provides ‘MUSE on Demand’ webcasts.
What is a MUSE on Demand webcast? An on Demand webcast is a recorded webcast that was
presented at a previous date to a live audience. It includes
both the web-based presentation and the audio component.
What is the difference between attending a live web-cast and viewing an on-demand version?
Viewing the on-demand webcast is no different at all than
attending the actual event.
Can I view it whenever I like?
Yes, you can choose when you’d like to view the on-demand
webcast – even if it’s 2:00 am!
How do I view a MUSE on Demand presentation?• Log in to the MUSE website with your user name and
password
• Select the ‘Events’ link on the top menu bar
• Click ‘MUSE on Demand’ link on the left side menu
• Scroll through the presentations divided by category
• Select the presentation you want to view; click on the
hyperlink
• Enter your name and email address when the registration
page opens, then click submit
• Enter your credit card detail when the e commerce page
opens and click submit. You can pay using Visa, Master
Card, Discover, AMX or Paypal
• The presentation will begin playing automatically
What if my program is interrupted or I have technical trouble?Please contact [email protected] for MUSE
on Demand customer service
Can I ask the presenter questions?
Yes, sometimes the presenter’s email address is posted on
the last slide. If it is not posted, email your question to:
Do you charge for all presentation in MUSE on Demand?No some presentations are free to MUSE members
View the library of MUSE on Demand presentations.
WINTER 2011 MUSE INTERNATIONAL 22
It’s an accomplishment when a hospital goes
live with CPOE; it’s a unique story when a
61-bed acute rural hospital with no 24-hour
pharmacy, no employed hospitalist, where
most physicians are in private practices, and
do all their own inpatient rounding, imple-
ments CPOE. Harrison Memorial Hospital
(HMH), located in Cynthiana, Kentucky, went
live with CPOE November 4, 2008 with its
pilot practices (four physicians and one
nurse practitioner), and by April 2009 all phy-
sician practices were live. Today approxi-
mately 98% inpatient CPOE is occurring with
only a few referral physicians writing orders.
One HMH physician, Dr. Stephen Besson, has
been instrumental in influencing the physi-
cians at HMH to accept CPOE. To successfully
adopt CPOE, attention to workflow and a
willingness to change is important. Some
physicians have adopted new ways of
rounding and some have tried to maintain
old habits.
Dr. Besson spoke with MUSE MATTERS
regarding specifics of the experience.
Ask Me about CPOE,A Physician’s Story
23 WINTER 2011 MUSE INTERNATIONAL
WINTER 2011 MUSE INTERNATIONAL 24
continue
MUSE MATTERS (MM): Explain a bit about the CPOE
implementation process at your
facility.
Besson: HMH choose a phased in
approach to bringing physicians
live with CPOE. We had two pilot
practices, one was my practice,
with three physicians, and the
other was a surgical practice (Dr.
Karl Schulstad). These physicians
went live with CPOE house-wide in
all locations which allowed for
streamlined problem solving and
around-the-clock support from the
IT Department. Other practices
were brought on board every
three weeks, with each physician
receiving one-on-one training and
individual support as requested.
MM: What are the most valu-
able aspects of CPOE?
Besson: Number one - More
targeted ordering with less
unnecessary medication orders.
Number two - Allergy checking
within the ordering process
prevents medication errors.
MM: How has CPOE transformed
your facility?
Besson: It’s actually changed
work processes both positively
and negatively.
Positive – Being able to access
the system remotely to place
orders and review patient results
has enabled me to be more inter-
active with patients and their
care.
Negative – There can be a loss of
verbal communication with the
nursing staff due to dependency
on electronic documentation
within the record.
MM: How is your role different
with CPOE?
Besson: I conduct my rounds
differently by use of mobile tech-
nology with reliance on the elec-
tronic data - versus a paper chart.
I also had to learn technology
with accessing the electronic
chart and from a care perspec-
tive, so I am more in tuned with
what needs to happen with
processing of orders.
MM: What do you think is
necessary for a successful CPOE
implementation?
Besson: Several things –
1. You need to make sure you
have at least one physician from
each care area, for example Medi-
cal and Surgical and possibly OB
on your CPOE team for guidance
during the building process.
2. There needs to be a pharma-
cist employed who is exclusive to
the implementation of CPOE and
can also be exclusive to some
degree once the organization is
LIVE. CPOE is 70% medication
ordering and upon live status
this does not go away.
3. 100% backing from hospital
administration is critical for those
physicians who might want to
appeal opting out of this process
– it is too difficult to have some
physicians who do CPOE and
some who do not.
4. IT support from both a hard-
ware and software perspective is
essential as well.
MM: What advice would you
give physicians who are hesitant
to implement CPOE?
Besson: It’s good to be hesitant
and do your homework, but also
understand it is going to happen
and it is better to be part of the
process rather than the process
dragging you along. This process
will be as easy or difficult as the
physician chooses to make it.
MM: Is there anything you
would have done differently
(lessons learned)?
Besson: From the physician
perspective things went as
smooth as could be expected.
However, more attention could
have been given to the nursing
work flow. Upon Live there was
some confusion as to how the
nurses would now pull orders
and process information through
departments.
MM: What other projects are in
the future for Harrison Memorial
Hospital?
Besson: We have recently
gone live with nursery physician
documentation - and I love it. We
will be looking at doing more
electronic physician documenta-
tion with templates and voice
recognition in the future.
Of course, meeting the goals of
Health Care Reform so that our
organization and private prac-
tices can take advantage of the
incentive dollars will also be a
focus for the next four years.
25 WINTER 2011 MUSE INTERNATIONAL
Biography: Dr. Besson is the Physician Champion who led the adop-
tion of CPOE for Harrison Memorial Hospital. Dr. Besson
earned his Medical Degree from Loyola University Chi-
cago Stritch School of Medicine. He was the Chief Resi-
dent of Internal Medicine at the University of Kentucky
Chandler Medical Center and is now the Attending Physi-
cian at the Licking Valley Internal Medicine and Pediat-
rics. He is affiliated with both Harrison Memorial Hospital in
Cynthiana, Kentucky and Nicholas County Hospital in
Carlisle, Kentucky. Dr. Besson is Board certified by the
American Board of Internal Medicine and the American
Board of Pediatrics.
Want to hear more of Dr. Besson’s story? Check out his
presentation, Ask Me about CPOE, A Physician’s Story, in
the MUSE on Demand library!
HMHHarrison Memorial Hospital
a Regional Healthcare Facility
CLUESCLUES
WINTER 2011 MUSE INTERNATIONAL 26
KEY BOARD TO MOUSE TO TOUCH
Let’s briefly look at the history of healthcare computing to understand why we’ve had good success in
financial, administrative and ancillary areas and also why clinical computing has been a challenge but is
soon to change.
In the 1970’s applications using terminal & keyboard technology started appearing in hospitals around
the country in the administrative and financial departments. In the 1990’s personal computers with
mouse technology coupled with graphical user interface became prevalent. Both of these paradigms
(keyboard centricity and mouse centricity) worked well for desktop driven users who primarily
worked in a stationary environment. However, clinical users on the floor have always lived in a mobile
environment. For these powerhouses, keyboard centric computing equated to a ball-and-chain tying
them to a desktop or a COW (computer on wheels) and altering their duties from being patient centric
to data centric. Moving to mouse driven applications provided some improvement but not enough to
replace the productivity and ease of use they had in a mobile and paper/pen driven environment.
What they lacked was mobility and an intuitive and natural user interface that could replace paper and
pen in a meaningful manner for the digital world.
A Touch of Class…A New Paradigm in Clinical Computing
continue
With ‘Meaningful Use’ on the horizon and its
emphasis on clinical IT usage, it is fundamental for
hospitals to ask themselves the following critical
questions:
• What has been the clinical computing experi-ence in the organization over the last decade?
• Are nurses, clinicians and physicians content with the current clinical computing environment?
• What type of software, hardware and user interface will ensure ‘Meaningful Use’ and enhance clinical computing?
HIGH TECH –HIGH TOUCH
All of this started to change in 2008 when Apple rolled out the Iphone
followed by the Ipad with multi-touch capability in 2010. The touch
screen interface, which we experience at ATMs, airports, and informa-
tion kiosks, has now become available to masses as a relatively inexpen-
sive computing device classified as a PDA (personal digital assistant)
and tablet.
This new technology paradigm called multi-touch responds to multiple
inputs by multiple fingers—even multiple users—all at the same time
which has transformed the way we interact with computers. How? For
example, take your thumb and index finger and push the tips of them
together, place them on the tablet and drag them apart while touching
the screen to make the screen appear larger. Amazing! These complex
gestures that can be performed with our fingers allow for so much
more than point and click technology. Touch-based navigation is now
available for clinical decision support, CPOE and much more. When
nurses and physicians can use their fingers to do what they want just
like they do with a paper interface at a patient’s bedside or in the
lounge, you have success in your hands!
Innovative healthcare vendors whose software platforms are built on
‘open technology’ have been able to respond quickly by delivering
native Apple Safari support for the IPHONE and IPad which provides a
true and easy to use interface for effective clinical computing. More
importantly, these vendors will be able to ride the tremendous wave of
progress and innovations that the multi-touch paradigm has started.
The world of clinical computing is at the beginning of a new paradigm
where a ‘touch’ will be at the core of ‘Meaningful Use’.
A Touch of Class…A New Paradigm in Clinical Computing
27 WINTER 2011 MUSE INTERNATIONAL
Kam Shams, Chairman The Shams Group
WINTER 2011 MUSE INTERNATIONAL 28
Have Your Company Listed
Contact the MUSE Commercial Member Manager
Tel: 877 491 4703 ext.2 Email: [email protected]
First DataBank 701 Gateway Blvd Suite 600 So. San Francisco CA 94080 www.firstdatabank.com Steve Pickford Tel: 650-872-4593 [email protected]
ClinicalDell Perot Systems 120 Royal Street Canton MA 02021 www.dell.com/meditechsolutions Corrine Cutler Tel: 781-401-2104 [email protected]
Consulting
Beacon Partners 97 Libbey Parkway Suite 310 Weymouth MA 02189 www.beaconpartners.com Peter Dolphin Tel: 781-982-8400 [email protected]
Thomson Reuters 7 Celebrie Court Kingsville MD 20187 www.micromedex.com/meditech Ron Tyszko Tel: 410-510-7417 [email protected]
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