Using standards to share patient information electronically—whether from hospital to physician office, hospital to hospital, or region to region—is the focus of many health information exchange initiatives. MEDITECH is dedicated to building care communities by connecting hospitals with other health care providers, insurance companies, medical suppliers, and public health agencies, while positioning our customers to be early adopters of health care information technology and interoperability. As the industry continues to move forward with developing standards for interoperability and achieving local, regional, and national goals, we took the opportunity to check in with Barbara Hobbs, MEDITECH's manager of EHR initiatives, to get her perspective on MEDITECH's efforts to support interoperability.

Q : What is MEDITECH's overall health information strategy?

A (Barbara Hobbs): In a nutshell, MEDITECH is dedicated to fostering interoperability between our customers and other vendors; communicating data using industry interoperability standards; developing working models at local, regional, and state levels; and improving reporting to local and national public health agencies. We've been working hard to keep up with national initiatives and to respond to our customers' individual needs as well.


Q: How is MEDITECH prepared to stay at the forefront of national EHR initiatives?

A: MEDITECH has really taken on a leadership role in recent years, and we've been actively working with key organizations involved in the EHR effort to lend our clinical and technical expertise wherever it's needed. Most importantly, we're working aggressively to ensure that our customers are well-positioned to be early adopters of interoperable electronic records. As the EHR movement progresses, MEDITECH will make sure that our customers are able to meet the challenges that federal governments set before them, as well as provide safer and more comprehensive patient care.


Q: Has MEDITECH been involved in any of the regional health information organization (RHIO) initiatives?

A: Most definitely. MEDITECH and its customers are leaders in working to establish RHIOs. As a company, we've recognized that there will not be one single interoperable solution to meet the needs of each community, so we have designed various models for interoperability to satisfy many of the established and emerging RHIO activities. Our solutions include centralized, decentralized, and various hybrid models for connecting communities. We also have established standard interoperability suites, so our customers have the opportunity to interface with other vendors.

We now have several customers who are creating and/or participating in RHIO initiatives or other interoperability projects, including South Shore Hospital and Northeast Health. In addition, one of the nation's first nationally recognized RHIOs, Inland Northwest Health Services (Spokane, WA), is a MEDITECH customer. Inland's system encompasses 32 hospitals and approximately 1,000 physicians, and includes Inland Imaging, Inland Northwest Health Services, Pathology Associates Medical Laboratory, and other affiliated clinics and organizations. Lastly, MEDITECH is working with the Indiana Health Information Exchange (IHIE)—an organization focused on creating an EHR within the state of Indiana through a centralized data center that they control via clinical messages from participating Indiana hospitals.  These are just some of the exciting RHIO projects we've taken part in that are helping to advance interoperability nationwide, and we can't wait to see these initiatives expand.   


Q: For hospitals who are interested in taking part in a RHIO project, what product offerings does MEDITECH have to support them?

A: In order to achieve optimal integration, MEDITECH and its partners offer integrated products that encompass the inpatient, ambulatory, and home care settings. Also, MEDITECH now offers standard interoperability suites, so our customers have the opportunity to interface with other vendors as well. While we offer several models and several interoperability interface suites for each model, data sharing implementations are highly individualized, so we plan to work with each customer to fully understand each account's needs and tailor our interoperability interface suites accordingly.

Q: In light of the numerous EHR initiatives that MEDITECH is now involved in, how has the company responded to the increased demand on resources?

A: We have added some very talented senior MEDITECH resources to our EHR group. They participate in industry working groups that focus on creating interoperability standards, such as the EHR Vendors' Association, Integrating the Healthcare Enterprise (IHE) workgroup, and the HL7 EHR workgroup. Moreover, they attend AHIC and HITSP sessions and focus on CCHIT's current process to certify inpatient EHR systems.

Additionally, we have a very talented Interoperability group on the technical side, led by Lori Messier (Client/Server and MAGIC), who are managing the implementations of all interoperability projects. Our Development division is also working on incorporating standards into our software, and will continue to evaluate the best possible way to incorporate industry standards, such as standardized nomenclature like SNOMED and LOINC, into our software.


Q:  Several organizations, including CCHIT, HITSP, AHIC, and HL7, have made recent announcements about national standards for health care information technology. How is MEDITECH prepared to deal with the recent standard developments?

A: MEDITECH has been actively involved in reviewing the criteria on all of these fronts, and we provide feedback when necessary. Many of these are in the preliminary stages and still need projects to test these standards in the field, but we are rapidly moving forward in the right direction. As we continue moving along with standardization and interoperability, we will evaluate how the emerging standards will impact our customers and their use of our system, and will prioritize how the standards can be incorporated into our software.


Q: Has MEDITECH adopted any of the suggested interoperability standards?

A: In March 2007, we successfully moved to production a model of the Cross Enterprise Document Sharing of Medical Summaries which is profiled by the IHE Patient Care Coordination framework. The HL7 Clinical Document Architecture (CDA) and Care Record Summary (CRS)/Continuity of Care Document (CCD) are used for information exchange between various acute care hospitals, using the MEDITECH HCIS and multiple physician practices. These standards for exchange, also identified by HITSP for sharing medical summaries, include the standards for Patient Identification Query (HL7 v3 PIX/PDQ) to EMPI or RLS services, a Cross-Enterprise Document Sharing (XDS) Registry Query, and a Cross-Enterprise Document Sharing (XDS) Document Retrieval. Additional standards and communication protocols, which we support include HL7, EDI, FTP, HTTP, HL7 MLLP, SOAP/Web Services, and API.


Q: Any final comments?

A: MEDITECH continues to be very involved with EHR initiatives at all levels, nationally and locally. We sit on many committees and attend meetings so we can provide direct input into the national EHR agenda. We have gained some valuable experience and have had much success over the past year supporting our customers involved in the different RHIO projects throughout the country. We're witnessing a very exciting time in health care, and I'm very happy to be playing a part in such an important process.