Several years ago, Guelph General Hospital (GGH), a 181-bed acute care facility providing a full range of services to the residents of Guelph and Wellington County in ON, Canada, expanded its MEDITECH hospital information system from a single facility to a total of four hospitals.
With the expansion, GGH added numerous departments, and of course, critical patient and financial information. As a result, the need to maintain current data records in all departments, across all locations, took on an even more significant role. For example, it is imperative to maintain accurate physician lists and billing and accounts receivable (B/AR) records to ensure a high level of quality care, effective communications among the hospitals and a strong revenue cycle.
With the prospect of such a massive influx of information, updating each of the departmental data dictionaries at each facility looked like a monumental task for GGH. MEDITECH’s workflow and processing is driven by the values in the dictionaries. However, synchronizing test and live dictionaries within a MEDITECH environment is not easy. MEDITECH mandates that a hospital build its dictionaries in test before going live with an upgrade, and MEDITECH charges thousands of dollars to provide that service.
Last November, GGH began synchronizing dictionaries from test to live for many modules, including Admissions, Blood Bank, Lab, Lab Information Systems, Management Information Systems, Order Entry, Radiology and Scheduling. Prior to initiating this project, GGH recognized that to build the dictionaries in test and then have to manually rebuild them in live would be a grueling job for the systems analysts. That approach is too time consuming and too prone to the errors and mistakes that human entry can cause.
“Synchronizing from test to live has always been labor intensive,” says Doug Mitchell, Integrations Analyst, Guelph General Hospital. “But without maintaining the two systems, we run into problems later on because it is necessary to effectively test new changes or enhancements before moving the dictionaries to the live environment.”
Automating Test to Live Synchronizations
GGH considered standard scripting tools to synchronize each of the departmental dictionaries. But it quickly ruled out that option when it determined it didn’t have the necessary skills in-house nor the time and money to bring a consultant on board to develop the necessary scripts.
GGH found a solution in UNISON™ from Boston Software Systems. UNISON is a standalone application designed to automate the tedious task of maintaining any departmental dictionary within the MEDITECH environment. It allows users to keep test and live dictionaries synchronized without spending hours of costly programming time. Within 20 minutes a user can create the synchronization and schedule it to take place regularly without human intervention.
Since beginning this project, GGH has synchronized approximately 70 dictionaries for all four sites and Mitchell estimates that by using UNISON, GGH has saved about 40 percent of the time they had planned for dictionary building.
“I can’t even imagine how much time it would have taken to get all this done manually and it would contain any number of errors,” says Mitchell. “Even using traditional scripting tools would have been more difficult. UNISON is designed specifically for dictionary maintenance so it’s much faster to develop and run the sync.”
The first phase in November included dictionary synchronizations for order entry, patient care inquiry (PCI), lab, transcription and radiology departments. In preparation for the opening of a radiology clinic, GGH built a number of new dictionary entries. Once the testing was done, GGH faced the challenge of moving the information from test to its live environment, including MEDITECH $T and Magic dictionaries. With UNISON, GGH avoided the need to duplicate its efforts and ensured what was done in test was reliably copied to the live environment.
To support $T, an older MEDITECH programming language, Boston Software Systems made enhancements to UNISON and, as a result, GGH was able to save countless hours of work
and avoid lengthy delays going live by synchronizing the following dictionaries: Magic MIS Location; Magic B/AR Procedure;, Magic Scheduling Resource Schedule; Magic Scheduling Appointment Types; Magic Scheduling Appointment Groups; $T Radiology Exam Types; and $T Radiology Exams.
For the other major applications, GGH began synchronizing many dictionaries around the middle of last November for a live date at the end of the month, and the synchronizations continued into December and January for different live dates.
Of the 70 dictionaries, some of the more critical ones like lab test were more difficult to
synchronize than others due to variable screens and pop-up prompts. “Automating the synchronization of just the Lab Test dictionary saved us 40 hours,” adds Mitchell.
Reuse Synchronizations for Easier Maintenance
GGH recently implemented the third phase of its lab dictionary synchronization on April 1. The IT department was able to reuse the same sync that it had developed in November. All it had to do was feed a different subset of tests, and the dictionaries were automatically synchronized.
Once a sync is built, a hospital can do several things to use it for ongoing maintenance. First, a user can continue to use the dictionary as is or replicate the sync, in order to do further testing and development and then sync it to live again. This requires no extra development time.
Second, a user can copy a sync as many times as necessary. GGH did that to process thousands of lab tests. It created one synchronization, copied it to create multiple versions running concurrently. GGH was able to zoom through the lab tests in a weekend with what had previously taken weeks to do manually.
Third, UNISON allows users to synchronize as little as one data element, one screen of data, or just certain sections of data. This gives users greater flexibility when maintaining dictionaries. For instance, if they only need to change one value, such as an ID number, across the dictionaries, they can sync for that single value rather than all the information in the dictionary.
Time Savings and Improved Accuracy
Using UNISON to automate dictionary maintenance delivers huge time savings when imple-
menting MEDITECH upgrades or maintaining dictionaries that change frequently. For example, if a system analyst were to implement a new MRI service in a hospital and had to build all of the tests and all of the exams in radiology, he or she would only have to build them once and then use UNISON to synchronize them.
Improved accuracy is another significant benefit from automating the task of keeping test and live dictionaries synchronized. It is monotonous work to manually replicate test into live, and it’s easy for a system analyst to make a mistake. Having a tool that does this automatically greatly improves the accuracy and quality of the data. It also frees the IT staff to do other critical projects, which require their time and attention.
For more information about UNISON please visit www.bostonworkstation.com or call us directly at 866 653 5105.
