Published on December 16, 2008
MEDITECH – HEALTHCARE INFORMATION SYSTEM SUNIL NAIR, B00492855 October 23, 2007 Healthcare organizations are a conglomerate of heterogeneous groups of professionals and consumers with diverse objectives and information requirements. The purpose of a healthcare information system (HCIS) is to manage the information that health professionals need to perform their jobs effectively and efficiently. HCIS: • Facilitate communication • Integrate information • Coordinate action among multiple users • Organization and storage of information • Support financial and administrative functions Major functions: • Patient Management • Departmental Management • Care Delivery and Clinical Documentation • Clinical Decision Support • Financial and resource management and • Managed Care Support MEDITECH 1 Medical Information Technology or MEDITECH is a software vendor in the health care informatics industry providing integrated software solutions to healthcare organizations. Founded in 1969, MEDITECH’s hospital information system has evolved with the changing trends and demands of the healthcare industry to integrate all components of the Integrated Healthcare Delivery Network 2 from primary acute care to long term care facilities. The system includes modules for managing patient information, patient care, clinical information management and financial and reimbursement management. A major step towards achieving integration was to make the system compatible with both platforms: a client/server-based Microsoft Windows setup, or the company's proprietary MAGIC operating system. In order to provide a multifaceted interoperable Health Information system to the heath organizations, the company works with other hardware and software vendors like IBM, Dell, Patient Care Technologies Inc., and LSS Data Systems. 3 Page 1 of 7
MEDITECH product suite: Source: http://www.meditech.com/PublicRelations/pages/product.htm Features and Benefits 4 • Management of billing, payroll, decision support, materials management, and staffing and scheduling. • Clinical Management of health information in areas such as patient registration, radiology, ambulatory, pharmacy, laboratory, emergency, operating room, medical records, and physician practice management. • Information Technology management in relation to patient and staff Internet access, as well as data archiving and integrated communications. • Integrated Serverless Backup (ISB) 5 The main advantage of ISB is the utilization of Storage Area Network (SAN). This works by creating a “snapshot” point in time images of an entire session. This saved snapshot can then be retrieved and brought “live” without the uncertainty of a database analysis/rebuild step. • Integrated Disaster Recovery (IDR) creates and splits off point-in-time data images with block-level replication of the data to local or remote “standby” volumes; these can be brought live without further recovery steps. Page 2 of 7
Budgeting and Forecasting This is a useful financial management resource for managers and policy makers. The feature facilitates access to current and past financial performances and financial data that could help in a cost/performance evaluation and influence prediction and planning for the future. Budget fields are standard for all departments therefore the results are more uniform enabling accurate analysis. The application utilizes information found throughout the entire Health Care Information System to create detailed reports on • Revenue Projections • Managed Care (Third-Party) Contract Analysis and Negotiation • Service Volume Projections • Reimbursement Projections. Cost Accounting The application utilizes information found throughout the entire Health Care Information System to create detailed reports on comparisons of actual and standard costs, fixed and variable costs, budgets, variance analyses, service profitability, and departmental responsibility. The Cost Accounting application facilitates budget preparation and cost and profitability analysis as it enables an organization to: • Analyze and report standard costs, by procedure, at the departmental and cost group level • Compare the cost of providing services to the reimbursement received for each patient and groups of patients • Develop budgets by product line via expected number of cases and by service unit for expected volume and standard costs. Complete Integration with the Entire System The application is fully integrated with other MEDITECH applications to streamline the flow of information, prevent redundant data entry and duplication of effort, and generate reports that contain the most up-to-date, comprehensive information. Information includes: • Historical data for standard cost development • Service units as they relate to billing and nursing procedures • Revenue and profitability statistics • Spending, volume, and labor variance • Procedure usage • Billing procedures • Productive labor hours and dollars. Profitability Reports When combined with the Case Mix Management application, Cost Accounting provides users with the features and functionality to generate multiple profitability reports based on various selection criteria. Features include: • A detailed Patient Service Unit Report indicates the total standard cost of providing services to a patient and compares this cost to reimbursement activity cost per day; this information is also available through the Patient Cost Per Day Report Page 3 of 7
• Patient Cost Analysis reports provide a comparison of cost, charge, and reimbursement data (in detailed or summarized format) for a group of patients selected Departmental Reporting The system creates departmental reports, which illustrate standard costs and service usage by department. These reports allow for budget comparison and variance analysis by managers throughout the organization. Departmental Budgeting The application provides managers with volume and cost data in order to help prepare budgets. • Using past data, the system develops profile service unit usage by user-defined product line(s) • By entering expected product line or service unit volumes for an upcoming year, managers can obtain expected volumes of service units and expected standard costs by department and cost group • Budgeting is possible by product line(s) and by service units based on actual volumes for previous periods. Data Repository MEDITECH's Data Repository provides health care organizations an open environment for powerful reporting and decision-support tools. • Allows organizations to report on clinical, administrative, and financial data • Provides fast, easy generation of reports • Supports off-the-shelf tools for analysis and presentation of targeted data • Data collected can be integrated with information from other vendors' systems, • Enhances efficiency of transactional system • Provides fast, easy generation of reports • Allows for graphical display of data Accepts Data from Other Vendors and Industries Other vendor and industry data can be incorporated into the MEDITECH system in several ways. An organization may employ one or maybe all of the below options: • Standard interface protocols. Validation and referential integrity checks occur when the data is filed in the application, as with any interfaced data, thus ensuring imported information conforms to the care organization's standards and established nomenclature. • By filing the data directly to the Microsoft SQL server • Customer-defined screens to capture and report on data from other organizations • Enhances Efficiency of Transactional System: multiple users can report on information in the Data Repository without impacting the speed of their live environment. Page 4 of 7
Access to Health Care Data for Reporting and Decision Support The Data Repository contains data from the clinical, administrative, and financial applications down to detail level. The Data Repository allows care organizations to: • Simplify report development through the utilization of standard column naming conventions • Study data to conduct business and research analyzes • Quickly analyze the broad scope of information and draw conclusions about patient treatment strategies, strategic planning, and outcomes reporting • Identify cost efficiency levels on an overall organizational basis, and on a provider-by-provider basis. Security Access to the data within the Data Repository is completely controlled by the security features inherent in Windows NT and the SQL server. This security is very flexible and can restrict user access to specified tables and/or columns in a table. Row level security can also be realized by the use of Views. Comparison There is a multitude of Healthcare Information systems in the market today. The evaluation and selection criteria of a HCIS depend on the type of organization and its requirements. The end users, Managers, Healthcare professionals and consumers look for companies that are • Cost effective • Training and learning curve • Implementation time • Technical support • Graphic user Interface – User friendliness Some of the current major players in the HCIS market are 3M, Cerner, Eclipsys, IDX, Meditech, Mckesson, Quadra-med, and Siemens to name a few. A comparison of the products by various vendors should include the type of Information System, overall product features, perceptions of the end users and the type of clients its serving. In this paper, Computerized physician order entry (CPOE) offered by three major vendors is evaluated. “Computerized physician order entry (CPOE), is a process of electronic entry of physician instructions for the treatment of patients (particularly hospitalized patients) under his or her care. These orders are communicated over a computer network to the medical staff (nurses, therapists or other physicians) or to the departments (pharmacy, laboratory or radiology) responsible for fulfilling the order. CPOE decreases delay in order completion, reduces errors related to handwriting or transcription, allows order Page 5 of 7
entry at point-of-care or off-site, provides error-checking for duplicate or incorrect doses or tests, and simplifies inventory and posting of charges.” 6 The following comparison report by KLAS 7 shows the market share holders in the year 2002. The following chart shows the overall vendor ratings in features and benefits. Page 6 of 7
Physician satisfaction with Inpatient CPOE system Source: The HIT report from KLAS -2004 As the above examples show perceptions vary according to technology acceptance of different groups of users and also the assimilation of newer more sophisticated IT tools by vendors in updating their current system. Currently there is not yet a fully integrated, inter-operable HCIS product available in the market. The healthcare sector being a multifaceted ever changing environment with its distinct requirements, there is a need for a fully functional, highly integrated, interoperable HCIS for a sustainable health system of the future. Reference: 1 http://dgplades.salud.gob.mx/2006/htdocs/daiss/Meditech_caracteristicas.pdf 2 http://healthadmin.jbpub.com/mhc/readings/chapter%2001/hcm%2018-4.p41-47.pdf 3 http://www.fundinguniverse.com/company-histories/Medical-Information-Technology-Inc-Company- History.html 4 http://www.answers.com/topic/medical-information-technology-inc?cat=biz-fin 5 ttp://www.bridgeheadsoftware.com/downloads/Press/PR07_ISBIDRforClientServer.pdf 6 http://en.wikipedia.org/wiki/Computer_physician_order_entry 7 www.healthcomputing.com KLAS Page 7 of 7
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