Millennium Medic

Serving up Answers at HIMSS

By David Hallberg

Buried in the alphabet soup of this year’s HIMSS sessions — EHRs, HIEs, ACOs, CDS, ICD-10, MU — is the reminder that expectations for HIT (healthcare information technology) continue to skyrocket and, with it, the number of EMR options you have to implement. Improved patient safety, affordable care, access to information and accurate recordkeeping all rely on the EMR system.

Is your system ready to meet these growing regulatory and public demands? How do you keep it running reliably and securely as new software and systems are integrated? Will you be at HIMSS later this month to get some answers?

If so, we’d love for you to let us know what you hope to accomplish at HIMSS. What sessions will you attend? What people do you want to talk with? What vendors interest you? You can start a conversation by commenting on this post.

If your hospital is running Cerner Millennium^®, we also invite you to come see us while you’re on the exhibit floor. We Millennium Medics will be in the Softek Solutions booth, #4056, ready to talk with you about any Millennium performance questions you may have. For the past three years, this blog has walked you through steps to troubleshoot common system issues and has sung a familiar tune: “Tune, Tune, Tune.” We have years of experience working with the Cerner system and are the geeks who love to talk about that kind of thing. Please come see us.

X Marks Our Spot to Meet with You at CHC11

By Chris Lanaman

If you’re one of the chosen few from your hospital coming to Kansas City for the Cerner Health Conference, you probably have a long to-do list: speakers, education sessions, exhibits, networking, a party or two. But I’m hoping you’ll strike out on your own at some point to visit with the team that’s been bringing you the Millennium Medic the past several years. Lucky Strike Lanes & Lounge just a few blocks east of the CHC activities will be our spot throughout the conference. Why do we think you’ll want to add us to your already busy agenda?

• We’re having a party, and you’re invited — Monday, Oct. 10^th, from 7 p.m. to midnight at Lucky Strike, 1370 Grand Blvd. We might be a bit biased, but we think it’ll be one of the best of the week. It’s Softek’s annual Client Appreciation Party, but we’re welcoming non-clients as well for an evening of food, games, music, bowling and lots of prizes (we’re talking cool electronics). Your CHC badge is your ticket to get in, or you can sign up ahead of time and get more details at the Softek website.
• Our Millennium experts are sharing their expertise. Where this blog is best used to address common system issues, a face-to-face meeting would let us answer your specific questions. Stop by Lucky Strike any time from Monday morning to Wednesday noon — we’ll even be there Tuesday night overlooking the Big Bash in the Power & Light District. Come talk with us and enjoy a free meal and bowling. If you prefer to set up an appointment, call Erin at 913.981.5242.
• We know more about your system than you might think. Softek conducts independent audits of the Millennium production environment, and we can show you what we’ve discovered in every audit we’ve ever run, findings that have huge clinical and financial implications.
• We’ve got our head in the clouds. Softek OnTrack’s new cloud access is part of our commitment to opening access to Millennium users to more information about their system. We’d love to tell you about it: Millennium whitepapers and user training at OnTrack University, user forums, mobile applications for system management and other resources.

The CHC will be a busy week for education, association and recreation. We hope to enjoy all three with you.

Going to Kansas City for the Cerner Health Conference?

Many of you will be in Kansas City in a few weeks for the Cerner Health Conference. We’ll be on hand as well from our “headquarters” at Lucky Strike Lanes & Lounge in the Kansas City Power & Light District a few blocks east of Bartle Hall and the CHC. We’d love to talk with you in person about your Millennium® system and will have more details in the next blog concerning our activities for the week.

Today, however, we want you to get excited about the city we call home. Here’s a list of 10 places you might not have thought to visit while you’re here…but are definitely worth considering. Our potpourri includes places that appeal to all sorts of interests: history, art, architecture, sports, music, barbeque (you are in KC, after all) and even potpourri.

1. The story of the sinking of the steamboat Arabia in the Missouri River in 1856 is just as fascinating as its discovery in 1987 buried 45-feet deep in a cornfield half a mile from the river. The Arabia Steamboat Museum in the River Market documents it all and displays the china, food, guns and clothing preserved in the silt. Outside the museum, explore the Farmer’s Market and stroll the Riverfront Heritage Trail to Berkley Riverfront Park.
2. The Money Museum inside the Federal Reserve Bank of Kansas City gives you a view of the automated vault and sends you home with a bag of cash (sadly, it’s shredded). Across the street from the Fed, you can appreciate the irony in the 65-foot-high sculpture of cargo containers at Memorial Park. Sculptor John Salvest’s installation spells out its title: “IOU/USA.”
3. The National World War I Museum is housed in the Liberty Memorial across the lawn from the bank. Its 55,000 items include everything from common soldier gear to rare artifacts. The “Man & Machine” exhibit shows German technology never before displayed in this country.
4. The National Archives west of the Liberty Memorial takes you back to an earlier war. The “Lee and Grant” exhibit contains artifacts and writings of two great Civil War generals.
5. The newly opened Kauffman Center for the Performing Arts south of Bartle Hall owes its impressive front facade to the 27 cables supporting the glass and steel structure. Tours are available, and multimedia artist Laurie Anderson performs “Transitory Life” at 7 p.m. on Oct. 9. For another KC architectural gem, visit the Bloch Building at the Nelson-Atkins Museum of Art. View 40 bronze sculptures by Auguste Rodin (of "The Thinker" fame) throughout the lobby.
6. Local entrepreneur Mary Carol Garrity, owner of the Nell Hill’s retail home stores, will speak at the downtown Kansas City Public Library at 6:30 p.m. on Oct. 11. Also at the library is an exhibit of original illustrations by Missourian Thomas Hart Benton for some of Mark Twain’s signature works.
7. KC’s most famous hometown brewery, the Boulevard Brewing Co., gives free tours (including tastings). Reservations are required. If you prefer the taste of coffee, visit the Roasterie Kansas City down the road from the brewery.
8. Celebrate KC’s rich music and food tradition at the annual Rhythm and Ribs festival Oct. 8 at the American Jazz Museum in KC's 18^th and Vine district. The daylong festival features top jazz and blues performers and local food vendors. Also at 18^th and Vine is the Negro Leagues Baseball Museum.
9. If you prefer a faster pace, visit the College Basketball Experience inside the Sprint Center. Besides learning all you want about the game, you’ll find lots of areas for play.
10. It’s race weekend at the Kansas Speedway just a short interstate drive west of the metro area. Oct. 8 is the NASCAR Nationwide Series’ Kansas Lottery 300, and Oct. 9 is the NASCAR Sprint Cup Series’ Hollywood Casino 400. Next to the track is the Legends outlet mall, several major retailers, land for the soon-to-be-built Cerner office buildings and the Livestrong Sporting Park. Major League Soccer’s Sporting KC plays Chivas Guadalajara at Livestrong on Oct. 12. 

You might be coming to the CHC to learn and spend time with colleagues, but we hope you also take time to enjoy a few of the places and activities unique to KC. 

Have You Talked with the Clinicians Today?

By David Hallberg

How do you begin to manage an EMR system as complex as Cerner Millennium^® — with a back end containing more than 35 million lines of code from Cerner along with Linux, AIX, HP-UX, VMS, Oracle, WebSphere MQ, Sonic ESB, MySQL, Java, storage area networks (SANs), networks, clustering software, network connections between Oracle instances, Citrix, Windows servers and desktops; with a front end that has more than 4 GB of space in its code warehouse; and with countless application builds?

I recommend you start your work by stepping away from your computer screens and talking to the people who are using the system to care for patients. Are they frustrated with response times? System availability? The number of clicks to admit or discharge a patient? Don’t dismiss their complaints with the assumption that “clinicians just don’t understand computers.” They are highly skilled people who understand the most complex system on the planet: human life. You might be surprised what you can learn when you take the time to really listen. Or shadow them during their rounds.

When I worked at Cerner, I brought my stopwatch with me to one hospital to join the CMIO and director of nursing informatics on the floor. It took more than 15 seconds to place one order in PowerChart^®. That’s an eternity when you’re with a patient and still have the rest of your rounds to complete. When I took the data back to the engineering lead responsible for the code, she emphatically told me, “Fifteen seconds is fast enough. They (the clinicians) just do not understand computers.” No wonder the clinical staff was frustrated. The system was hampering their ability to provide patient care, but their concerns weren’t given any consideration by the people capable of addressing the problems.

So I encourage you to gather the staff’s list of concerns, criticisms and objections. If they feel they’re not normally heard, no matter how bad their experiences, don’t be surprised if they’re distrustful at first and reluctant to talk. Keep at it. Move through the obligatory moans and groans to get to their true desires.

Now that the easy work is done, begin to rebuild their faith in the system by evaluating each complaint against each need and determine how to address them. You can use Millennium’s greatest asset, its flexibility, to configure it for very specific purposes. If the issues outweigh your staff’s ability to correct them — we’re back to that complexity I mentioned earlier — don’t be too proud to seek outside help. (If you’ll be at the Cerner Health Conference next month in Kansas City, I’d be happy to listen to your system concerns and talk through some options.) Then you can begin the journey of reconfiguring this multifaceted solution set into the system your clinicians actually enjoy using rather than avoid using or simply tolerate.

Learn about EMR Auditing at HIMSS

By Chris Lanaman

I’m heading off to the HIMSS11 conference in a couple days to mingle with some of the nearly 30,000 healthcare IT professionals descending on the Orlando Convention Center. While some might get sidetracked by Mickey and his friends, you’ll find me every day of the show with my Softek colleagues in booth 3221. If you’re going to be there, I’d love for you to stop by and meet with us.

I think our message at this year’s show is worth hearing: Every hospital would profit from an independent audit of their EMR system. Just as their care delivery must meet certain objective standards set by the Joint Commission and their financial operations undergo regular auditing, hospitals can use EMR auditing to see if their system is efficiently handling transactions and properly interfacing with its myriad subsystems. Where EMR performance is lagging, adjustments can be made — and patient care and safety improved.

I found an educational session that will make the same case. Dr. Dean Sittig, a professor at the University of Texas Health Science Center is speaking Tuesday morning on “Inspecting EHRs to Ensure Safe Use” in which he will “describe how to implement an annual EHR inspection program … to ensure that their clinical systems are functioning as designed and are being used safely and effectively.” 

Since joining Softek last fall as Director of Millennium Consulting Services, I’ve been involved with a number of such evaluations. Many clients have been surprised at our findings. We commonly find lost charges, queuing backlogs, bottlenecks throughout the system and even clinical information that fails to make it to the patient record. Following our report and recommendations, one client reduced wait times across the organization by hundreds of hours a month. That makes for a lot of happy clinicians and support staff.

Prognosis: A peak-performing EMR system is vital for reaching your goal of optimal healthcare delivery.

Meeting face to face

We want to thank those of you who were in town this week and stopped by to talk to us. We learn much when we meet you face to face and hear about the issues at your site. Future posts will address how to improve your system’s performance in these areas. If you’re lingering in Kansas City a little longer this week and would still like to meet with one of our medics, give us a call at 913.238.3205. We’ll schedule a time to talk with you.

We're sorry that technical problems last week prevented our post from reaching subscribers. We've corrected the issue and will give you the rest of this week to digest all the meat it contains on determining and alleviating queuing issues in Oracle. We’ll continue with our series on throughput issues next week, specifically in the area of application and database capacity.

Stepping into the RUGs

By David Fletcher
We barely got back from the Windy City (and the snow in April!) after four whirlwind days at the HIMSS09 conference and have got our bags packed again…this time for nearly four whirlwind weeks. Softek reps are attending and making presentations at the Cerner RUGs starting this past weekend in Niagara Falls and are eager to talk with as many of you as possible.

The RUGs offer you a setting to meet with and learn from fellow Cerner users in your region, and they offer us a more intimate venue than HIMSS in which to hear your ideas and concerns. We value these interactions with you because they help us determine ways we can further equip you in your management of Millennium. Please stop by and talk with us. Then watch this blog in the coming weeks as we address your issues.

It was great to talk with a number of you at HIMSS. For those of you who haven’t been to a HIMSS conference, the primary focus is on healthcare IT solutions – both in hardware and software – and this year was no exception. I managed to break away from our booth a couple of times and spend time just walking the exhibit halls, taking it all in. Certainly the economy had an impact on the attendance, as I wasn’t crushed, herded, or stuck in enormous lines, and to some extent it seemed that the exhibitor booths had scaled back as well. But all of the major players were there: Philips, Siemens, GE. Microsoft was showcasing their EMR solution, Amalga, which looks to be interesting for single facility organizations. I was grateful to share floor space with these industry giants and to be part of a company whose vision has always been, and will continue to be, empowering healthcare through software innovation.