We have heard some observers say that the meaningful use requirements could have unintended consequences in the health IT marketplace, perhaps forcing vendors to rush new versions to market. Well, in writing up something about a recent KLAS Research report on Meditech 6.0, I think I came across an example.
In May, KLAS Research published a report about some of the challenges CIOs are having with the transition to Meditech 6.0. The report found that many providers surveyed about their move to 6.0 said they have lost integration, speed, and reliability, as well as some reporting capability. In KLAS’ overall EHR performance scores, Meditech 6.0 trails many other systems. I recently spoke with the report’s author, KLAS analyst Jon Christensen, about some of its findings.
Rather than waiting for 6.0 to mature, many Meditech Magic customers transitioned early because they were concerned about meeting meaningful use Stage 1. Some Magic customers attested to Stage 1 of meaningful use, but looking ahead to Stages 2 and 3, they believed they needed to update their user interface to get better physician buy-in, Christensen explained.
Some of these CIOs blame meaningful use for 6.0’s immaturity, believing that Meditech would have had more resources to improve the product if it were not devoting so much time to meeting certification requirements. “There is some validity to these complaints about meaningful use,” Christensen said. “Meditech is supporting three different products and is stretched thin. When people jumped to 6.0 for meaningful use reasons, the company didn’t have the resources to do the necessary handholding.”
The KLAS report notes that although Meditech has some larger customers, it is typically considered a small to midsize hospital solution. But its customer base is decreasing in overall numbers and shifting toward the small hospital space (fewer than 200 beds). In 2010–2011, Meditech gained six hospitals over 200 beds, but lost 51, according to KLAS. “The larger facilities kicked the tires on 6.0, but many of them moved to Epic or Cerner,” Christensen said. “Meditech has had some gains and some losses among smaller hospitals. Long-term, its 6.0 base will grow, but overall market share will probably decline.”
Despite the challenges, the KLAS report notes that 95 percent of organizations on Meditech 6.0 plan to stay. Of course, that 95 percent number doesn’t include those that never went live with 6.0 and switched to something else, Christensen noted. “But the ones that did go live are deciding to stay with it. A lot of these are small hospitals that don’t have the time and resources to devote to exploring switching to other systems. Meditech has a cost-constrained customer base and that is not easy for them.”
One CIO who has been vocal in detailing his hospital’s challenges with the transition to 6.0 is Jorge Grillo of 99-bed Canton Potsdam Hospital in Potsdam, N.Y. He told me the issues mentioned in the KLAS report mirror his experience. For instance, the KLAS report mentioned emergency department physicians “specifically report workflow limitations and numerous clicks as impediments” with 6.0. At Canton Potsdam, the ER physicians refused to use the module and the hospital allowed them to choose a best-of-breed system instead, Grillo said.
Many hospitals on Meditech have small staffs and are challenged because they don’t have clinical informatics expertise. “With Magic, we had one clinical and one financial analyst and that was all we needed,” Grillo said. With 6.0, I have two financial analysts and need a third, and we have six clinical analysts. An outside consultant had estimated that it would cost $2.8 million to transition to 6.0. When I arrived, I told our CFO that I thought that number was way off and would be closer to $5 million. With the employees we have had to add, that number today is closer to $6 million.”
The KLAS report mentions that recent 6.0 implementations have gone better and performance scores are up four points over the past year. Grillo added that Meditech has done a lot of hiring of support staff and now has a strategy to help make implementations more successful, and that he believes the company will take a more structured and prescribed approach to implementations. (He sits on its 12-member CIO advisory council.)
“Usability is a key issue,” Christensen said, and 6.0 is not at the same level as other EMRs in that category, he added. “If CIOs can’t get the system usable in terms of CPOE or medication reconciliation, they won’t get the high adoption rates they need to meet meaningful use requirements,” he added. “That is a real pain point for them.”