Message from
Senior Management

Caring for Customers

Frank Fortner
Senior Vice President, Application Software Division

Message from
Senior Management

Caring for Customers

Frank Fortner, Senior Vice President of the Application Software Division

At Iatric Systems, we believe everything rises and falls on customer care. From development to implementation, support and administration, our focus is on giving our customers a positive, memorable experience. Having said that, not long ago I was thinking about the term "customer care" and its implications at face value. The term seemed almost odd initially. Why not simply say customer service or support? Why care? Yet, there are all kinds of "care" types including: car care, child care, lawn care, pet care, hair care (not so much in my case) and of course… health care. As I thought about customer care in light of health care, I began to see some interesting parallels that helped me better understand what customer care is really all about.

The majority of us, whether we work for a vendor or a hospital IT department, have customers who look to us to solve their problems. Surely everyone remembers some really tough days at work when software was not working as designed (or worse - we were told it WAS "working as designed") and our customers were freaking out as an IT apocalypse was unfolding in epic proportions. Without first-hand knowledge, that's what I might imagine working in an ER or urgent care facility would be like. That's when it hit me. We really do provide a level of "care" and it's not entirely different from how health care works.

Let me explain. Many patients, by the time they see a nurse or doctor, are sick or hurting, possibly depressed, highly emotional, maybe even irrational and acutely focused on solving their current problem(s). To their credit, health care providers understand this is all part of their job and it allows them to perform at a high level in the middle of a patient's crisis. They aren't going to take it personally if patients vent a little in their moment of sickness.

Like it or not, in the world of IT, our clients come to us in very similar ways at times. They are often under high stress, sleep deprived, perhaps even fearful for their jobs and maybe a little less friendly than their usual smiling selves. Still, we are paid to professionally solve their pain points. That means we need to show empathy and extend grace, understanding that (much like the ER doctor or nurse) this IS exactly what we signed up for.

So the next time your customers are having a bad day and letting off some steam, it may help to do what we at Iatric Systems do. Just think about that skilled ER nurse or physician who calmly and politely does their job, treats the patient, and moves on to help the next in line. It's an inspiring model for being the best customer care providers we can possibly be - and one we take very seriously.

CPOE: Problems, Orders, Results all on one screen?
You’re not dreaming. OrderEase.

CPOE is one of the most important goals your hospital will strive to accomplish in 2012. Ensure its success with OrderEase from Iatric Systems.

Watch this 3-minute video to see a CPOE solution that:

- Physicians love because it was designed by physicians, for physicians
- Accomplishes CPOE with the fewest keystrokes possible
- Presents problem lists, orders, results and medications all on one screen
- Helps MAGIC sites save money and preserve their MEDITECH investment

OrderEase gives physicians what they want. It allows you to save your hospital’s MAGIC investment. It helps achieve Meaningful Use.

Watch this video to find out how.

Then contact us to learn more at info@iatric.com or 978-805-4100.

Upcoming Webinars

Iatric Systems is offering several upcoming webinars covering a wide range of solutions to your most pressing issues. Whether your challenges relate to patient portals, managing pharmacy workflow, pharmacy solutions, barcoding specimen collection or meeting Meaningful Use, we've planned a webinar to help you.

Register now for the sessions. Iatric Systems product solutions can help your facility improve patient care and advance your hospital's clinical, financial, and administrative capabilities.

For more information on these webinars, please contact Amanda Howell at Amanda.Howell@iatric.com or 978-674-8121.

We look forward to seeing you online!

Save the date for HIMSS 2012
Iatric Systems Booth #7905 is a "must see."

Integrated Solutions For Your HIS

In order to get the most out of your Health Information System (HIS), you need tightly integrated solutions so your hospital can:

- Improve patient care with interoperability
- Connect with your regional Health Information Exchange
- Meet Meaningful Use objectives
- Support your Accountable Care Organization (ACO) efforts

Booth #7905 at HIMSS 2012 promises to be the best source for integrated solutions for your HIS and your most entertaining stop.

Eight times a day, Chef Anton—the two-time National Pool Trick-Shot Champion—will line up one amazing shot after another and award great prizes after each show.

DATE: February 20-24, 2012
LOCATION: Venetian Sands Expo Center
Las Vegas, NV
Booth #7905
info@iatric.com
himss.iatric.com

PLUS, don't miss the fun and prizes.
Booth #7905 is the place for you to get valuable information and have fun, too.

Don't miss HIMSS 2012 and don't miss Booth #7905.

Revenue Cycle Improvement Tips

Kay Jackson, Manager, Software Certification, Compliance and Financial

Why are hospitals considering Accountable Care Organizations (ACOs)?

HHS announced last month that the Pioneer ACO initiative will encourage primary care doctors, specialists, hospitals and other caregivers to provide better, more coordinated care for people with Medicare and could save up to $1.1 billion over five years^(a). Even with a more lenient version of the ACO final rule published^(b), physicians feel that they cannot accept greater financial risks^(c). So, if physicians do not sign up to participate, how will hospitals gather their ACO professionals to serve the at least 5,000 Medicare fee-for-service beneficiaries required?

ACOs participating in the Shared Savings Program will continue to receive their traditional payments for services for Medicare patients and also may receive additional remuneration for managing the Medicare patient population in a more economical process while also meeting several quality benchmarks. So as a hospital group considering creating an ACO, what could impact your success or failure? Factors to consider are:

1. The assigned patient population - The proposed rule indicates that both aggregate and person-level data will be made available to ACOs to “assist ACOs in the overall redesign of the care process and coordination of care in their assigned beneficiary populations.”
2. The ability of the ACOs to perform and positively score points in the four domains set forth in the Final Rule's quality performance standards (patient/caregiver experience, care coordination, preventative health and at risk population).
3. The ACOs existing infrastructure.
4. What needs to be added to the ACOs process to create effectiveness?

The more I read about ACOs, the more I wonder how it will all work. Will the smell of Meaningful Use money put ACOs on the back burner when more tangible incentives can be received now with Meaningful Use? How easy will it be to get all caregivers to agree on a patient's care plan and share the rewards or failures? A few weeks ago I read the article entitled “4 Reasons to Wait on ACOs” and I recommend reading it before making any ACO decisions ^(d).

Sources:
(a) http://www.hhs.gov/news/press/2011pres/12/20111219a.html
(b) http://www.cms.gov/aco/downloads/Appendix-ACO-Table.pdf
(c) http://www.fiercepracticemanagement.com/story/half-docs-unprepared-acos-more-financial-risk/2011-12-07
(d) http://www.healthleadersmedia.com/page-4/LED-274402/4-Reasons-to-Wait-on-ACOs

Next Month - Part 3: What could change with ACOs and is America ready?

NPR Report Writing Tips

Joe Cocuzzo, Vice President – NPR Services

NPR Tip: Stripping characters for a Download Report

This month, we will show you an easy way to filter output in a download report to remove characters which will cause problems for the parsing of fields and records in the receiving system. A simple example would be when the other party asks for a comma delimited file without “quote qualifiers”. In such a file, you need to remove any commas in the data or the comma in the field will be interpreted as a record delimiter. A more complex example is XML output, where you have to filter for certain reserved characters and replace them with some alternate text. Additionally, we will show how you can suppress the “Record Limit Reached” message from the end of your file that will otherwise be included. This can be inconvenient if you are using the record limit feature to make a sample file for an outside party because they will typically object to the extra data at the end of the file, and it can be tedious to remove it by hand.

Let’s look at the simple case where the other party wants a comma delimited file without quotes, making it impossible to send any data with an embedded comma. Since a MEDITECH patient name field always includes an imbedded comma, we will need to remove it, and it is probably a good idea to screen all fields that might include a comma to prevent the stray name or comment field from causing problems.

One way to remove all commas in a field would be to check each character in the string by position and remove the character if it is a comma. We use the “Not #” syntax to strip the offending character: Notice that the DAT attribute of all the fields on the report are set to INT. This will suppress any quotes around non-numeric fields (by treating them as numeric). You can do this to a standard field also, but if you do it to a date, you will change the format to YYYYMMDD, unless you use a computed field and %Z.date.out.

You can also change the data type of a standard field by adding a DAT= attribute:

This code puts the data from the field into a variable “STRING”, takes the length of the string, and then loops from position zero to the last position in the string, stripping out any commas found.

This will work fine, but there is an easier way, using the L() locate function in a DO loop:

An advantage of this approach is that if you had multiple characters to strip, you can just string them together in the L() function arguments, like so:

Here we are stripping the commas, hyphens, and periods from the string.

If you want to replace the comma with a space, we need to use $ (to the left) and % (to the right) with a space concatenated (_) in the middle:

If you have a lot of fields in your download, you can create a macro as a program and use it from your computed field. Assuming you write a utility report called MIS.USER.zcus.is.strip and call the macro “comma”: (I have placed a report with this name in our library).

The code in the macro looks like this (we replace the comma with a space in this utility):

Here is the output of a report that uses all these methods to strip the comma from the name field:

Let’s look at a more complicated example, such as an XML formatted export where we need to look for certain reserved characters when we are putting data between tags, and substitute a string for the reserved character as follows:

Character	Substitute
>	>
<	&lt;
&	&amp
%	%#37;

We can write a utility macro called “xml” that strips them as follows:

Notice that we have a two-step process to fix “&” and turn it into “&amp”. That is because if we directly searched for & and replaced it with &amp in a DO loop, the loop would be infinite as it would find the & in the “&amp” and be stuck until the string exceeds 255 and the program crashes. To solve this, we replace with “*amp;” first and then change the “*amp;” with “&”.

C/S and MAGIC versions of these example reports ADM.PAT.zcus.is.eupdate.strip and MIS.USER.zcus.is.strip has been uploaded to our report library. http://www.iatric.com/Information/NPRReportLibrarySearch.aspx

You can find additional NPR Tips on our website at http://www.iatric.com/Information/NPRTips.aspx, as well as information about our on-site NPR Report Writer Training and NPR Report Writing Services.

Read Joe's blog posts at MEDI-Talk.

To subscribe for email notifications for new classes, please follow this link:
http://www.iatric.com/Information/Classes.aspx

For more information or to reserve a seat, please contact Karen Roemer at 978-805-3142 or email karen.roemer@iatric.com.

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