[MT-L] Magic 5.64 (soon to be 5.66): OBIX, Meditech and Meaningful Use
Carla Fuller
For those of you with Obix, are any of you just using the “phase I,” (strips/tracings with notes included or not included on the strip itself?)
We are wondering how you attested for meaningful use, do you have an interface to bring the notes back into Meditech? Are vitals done in both systems? Are meds documented in Meditech only? Do your providers document in Obix? If so, do they have some sort of e-signature?
What is your process for auditing Obix for routine user audits? Currently our IS Team audits 25 random users per month throughout the system. This information is provided to the Privacy Officer for review and follow-up. Do you have a process that is similar for your Obix System?
Sorry that I am all over the place, we have a million thoughts and questions related to the impact Obix has when it is used for more than just a fetal monitor strip system.
Thank you,
Katie
Katie Wood, RHIT
Information Systems
War Memorial Hospital
Sault Ste. Marie, MI 49783
David Brown
Hi Carla,
The facility I am supporting went up with OBIX earlier this year with version 6.4 with version 7.0 due out this summer if not already.
Issues: First determine what is certified with OBIX for Meaningful Use and this can be done on the Government website for any EHR including modular ones, OBIX was only certified with its reports.
Interfacing: One only, ADT inbound and nothing else, so no data flows anywhere and the method in which OBIX obtains date is a completely different format than Meditech.
Med Rec: No functionality.
Allergies: Field to input but no interface to PHA.
eMAR, none. Data input only with no ability to scan patient or medication.
Results: None, no interfacing available.
Orders: None, no interfacing available.
The facility I am at had to continue to use Meditech for all users in every capacity as it is the primary legal EHR. The Nurses still have a condensed Admission assessment solely to capture Core Measures, Ht and Wt for pharmacy, attributes to launch them to Allergies and Med Rec to reduce navigation but still live on the Status Board to see new orders, next med, and results. To place orders, they navigate from the status board to place orders.
With birth of the baby, there is a newborn assessment to capture the same information required for mom, Meaningful Use and Core Measures. First set of vital signs are all capture in Meditech and OBIX, after that all the remaining Vital Signs are placed into OBIX. If the patient is going to OR for a C-Section, Pre-Op Checklist is completed in Meditech so OR can view it.
Since no data flows to Meditech via an interface, the patient record for mom and baby are printed and scanned into Meditech, the amount of memory required is huge and the server had to be compacted to accommodate more data. Moms typically generate 150 pages with baby about 90, lots of scanning and memory issues, not to mention additional work for HIM, Billing (looking in two systems to capture all the charges).
Alternative: You could still purchase OBIX for the digital tracing, it is stored in its own server regardless and only printed out in case of need to print the entire legal record otherwise it’s available when needed from that storage. Then optimize Meditech OB documentation for the purpose of OB Documentation with a good design, functionality, and all your data exist within the system. Providers do not document in OBIX, it’s a view only for them, and they still order in Meditech, review all clinical data in Meditech, and if using PDOC (which is planned in the future) why use OBIX except for the digital tracing to see how baby is doing? One site is using Meditech open and the digital strip associated to that patient. There is a monitor board for all rooms to display the strips at a glance besides being able to bring it up at each bedside work station. User give meds in Meditech (scan the pt and med), all functionality for patient safety exists within Meditech.
Process and workflow requirements for all departments (not just OB) have to be addressed on what the impact will be. This should drive your decision second to money and how this purchase will give a return to your facility financially.
Now, that all being said the up side, OBIX has signed an agreement for developing interfacing to Meditech (this site is MAGIC) so when will it be ready, unknown. Now, possibly other OB Vendor applications will interface to Meditech better than OBIX, but all the same questions pertain. Even with the assistance of Iatric or other interface specialists, there will be more cost and man hours to design, build, test, and implement than just purchasing the application. Hardware costs will definitely come into play.
How easy is it to use? Most of the users are finding not very friendly to find specific information due to the documentation as a ‘Line Item’ format and having to do a key word search versus just clicking on review and then the specific assessment as you currently do in Meditech. It has its restrictions between what they call forms and sheets. It does have strong report and graphic ability, but not at the expense that I have seen during this project.
Why did this happen? I suspect not all the right people were present to ask the correct questions that address the limitations and cost to overcome those limitations. This facility went live with 3 vendor modules with added cost, decreased interoperability, more man hours (including one full FTE that was not originally budgeted to monitor for failures between the two systems). No one thought of the processes and requirements to ask of those questions, it was one of those things someone has seen it or used it and liked it . . . . . but none or very few of the really important questions were asked.
Hopefully this is helpful-happy shopping.
Regards,
David E Brown, RN, BSSE
Senior Healthcare Consultant
Cell: 509-991-5874
Office: 509-340-2535
“Transforming Healthcare, One Hospital at a Time”