Tuesday, May 7, 2013
A Bold New Vision for Meditech
I have no financial relationships with any EHR vendor, but feel a great affinity for the vendors in Massachusetts - eClinicalWorks, AthenaHealth and Meditech.
For the past few years, I've suggested to Meditech that cloud hosted, standards-based, web-centric and mobile enabled hospital information systems would be very welcome by the marketplace.
The industry has had a mixed reaction to Meditech version 6, a proprietary, non-standard, non-web, non-cloud, non-mobile, client/server application that requires complete hardware and software replacement when upgrading from version 5.
I spent last Monday afternoon at Meditech and can tell you that they have listened to industry feedback (and my obsessive focus on web-based applications).
The Meditech senior team demonstrated version 6.1, a cloud hosted, standards-based, web-centric, mobile enabled, ambulatory and inpatient, analytics backed, personal health record enabled, and care managed focused application that will be shipping in 2014.
What did I see?
A new ambulatory EHR written from scratch to work on iPads supporting a voice-based or typed workflow. Some vendors have created two applications often with different copies of the data- one for the desktop and one for mobile devices. Meditech has wisely optimized the 6.1 EHR application for multiple devices using the same architecture from the same database. LSS, the previous ambulatory application, will be replaced by the new application that includes very friendly medication management, clinical documentation, and order entry tools.
A new Meaningful Use Stage 2 compliant Hospital Information System that is available anywhere without Meditech specific client software. The Direct protocol for interoperability is fully enabled.
A new PHR written from scratch designed for mobile devices and including many advanced wellness/preventative care features.
A new analytics platform that includes self service data mining tools
A new "post EHR" application that synthesizes the lifetime experience of the patient and enables non-physician care managers to ensure patients are receiving optimized care per protocols.
Everything was demonstrated via an iPad.
They are also working on applications to support anesthesia, ICUs, and infection surveillance. My only advice to them was to create a few full featured, highly usable products rather than try to launch an entire suite of products simultaneously that lack comprehensive functionality. The 6.0 product was a complete re-platforming for Meditech which resulted in some upgraded products not having all the features of their 5.x predecessors.
In the past two years, Epic has gained a very large share of the hospital IT marketplace. Since competition is a good thing for the industry, I'm hopeful that Meditech 6.1 will be very attractive to hospitals which want to implement a modern platform at an attractive price.
Meditech's new vision is bold and in my opinion, right on track.
I'm eagerly awaiting the production delivery of 6.1.
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4 comments:
John,
You and I have been together in a number of groups over the years, and I too have expressed my frustration with Meditech's lack of adherence to "standards" over the years. While 6.0 was a step in the right direction, there were a number of missteps and oversights in 6.0. We all know that a vendor needs to get something to market quickly to be able to recoup development costs, but there is a fine art to determining when a product is ready for prime-time. Likewise, most in our industry is aware of the concept of "Moore's Law" - Intel co-founder Gordon Moore's observance that basically technology capabilities double every two yeras. Historically, Meditech's capabilities have failed to live up to the expectations of Moore's law, and that is why 6.0 was such a huge step in the Meditech community.
My fear is that Meditech will bring 6.1 to market with a cloud-based, web enabled product that runs on multiple platforms, and that the same underlying architechture will be in-place in 10 years even after the marketplace has moved forward.
I remember when I opened up a new hospital for Methodist Healthcare in Houston back in 2000. We installed Meditech's Client/Server with full clinicals during that installation. I wanted to do some things different in that new install - some new technologies, some not so new. However, we couldn't get Meditech to support WAN VPN connectivity, even though such technology was commonplace in 2000. I personally have never seen a "technology" company so slow to adopt new technologies as Meditech. I still fight this battle with Meditech, trying to get the company to support true enterprise architechture. Don't believe me, just see the hassle you have to put up with when you try to get Meditech on-board with the transition of data to a NetApp or Compellent SAN, or the use VMWare in a true enterprise configuration - not just a configuration devoted strictly to Meditech.
While I applaud John's findings of 6.1's capabilities, I worry that the system will not be kept up-to-date with new, emerging technologies and will become obsolete soonafter introduction. Sorry to be a naysayer in this context, but when dealing with Meditech lately, my experience is one where you can't even get wireless access in their conference room, and their Application Specialists can't deliver a Microsoft Project Plan for an implementation. My confidence isn't just based on the product, but the behavior of the company in general.
MEDITECH is proud to admit they are building their own proprietary web server for 6.1 instead of using a standards based open source or commercially available one. Mass pride will soon be their downfall.
John,
I found your post incredibly informative, and your take, very insightful. From your comments, as well as Spencer's(above), it's clear that the opinion on Meditech is that they continue to struggle in their delivery of advanced technology - and I feel this is a reflection of the strategic direction and innovation provided from their organization as a whole. As a health system, making a long-term decision (10 years), I don't believe I could entrust the future of my organization's on a relationship with them. Perhaps, if there were an opportunity to re-evaluate in 10 years, and they'd shown significant progression in areas of: Integration, Analytics, and Predictive Modeling, then I'd consider. Many Meditech clients are much like the vendor - reactive. Unfortunately, that is what has fed the massive M&A movement over the past 5 years, and will be the downfall to organizations in a reimbursement world where those who are leading are "winning", not the followers. At this moment, if I am a health system, I am only considering Cerner and Epic. It's interesting which organizations favor these vendors. It appears to me that organizations that are still very transactionally-driven and concerned with Physician Billing, are selecting Epic. While many organizations that are focused on system agnosticism, and leveraging a variety of data sources to drive Population Health - are choosing Cerner. Someone go look what Advocate Health is doing. I will say they are the first to truly approach Population Health - and that strategy is one we are following closely!
While the comments that John expressed show some encouraging signs for Meditech - they were largely comments directed for the provider side. But what about the patient? Who is speaking up for them?
Meditech's patient portal product lacks mobile functionality at this time. As mobile technology continues to grow and more people use mobile to access information - why wasn't this taken into consideration before now?
The last I read Meaningful Use is largely a way to keep the patient engaged with their health record with the provider - not just the provider accessing the information.
So when will that be part of this conversation? Sooner than later is my hope. Before it's too late.
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