Friday, July 19, 2013

What are Webinars Worth?


I was recently explaining to my grandmother how webinars work and why they’re such a valuable tool for business communication. She somewhat understands, but the generational and technological gaps still leave her a bit mystified.




 

 My grandmother and her young daughter (my mother) traveled several hours to visit her father and grandfather – apparently what folks did in the days before Skype and Facetime.
 
 
 
When she was my age, connecting with someone who did not live nearby meant planning a trip to physically meet with them, writing a letter that could take weeks to arrive or making a costly, static-laden telephone call. I live in an entirely different world where I text message, email and chat with my colleagues and co-workers in another country on a daily basis.





In 1952, Bell Telephone offered a “deal” of $1.10 per minute Dallas to Denver. That would be about $9.00 per minute today. Great deal, right?
 
 


So what is our communication technology, specifically the webinar, worth? Can it even be quantified?

Sort-of; it comes down to this:

1) Convenience

2) Immediacy

3) Affordability

Still with me? Good, because here’s the point of my post. As an organization that thrives on connection, my goal at MUSE is to provide you with the best way to “visit” your peers. The webinar earns a shiny star in this category; it’s the teacher’s pet in the connection classroom. Although I am certain that 98% of you are familiar with the functionality, for that 2% who are not I give you this: A webinar is a conference or presentation using a computer and a telephone to transmit and receive the information. You can even attend using just a smartphone, too!  It is no different in terms of the information and value gained from participation than from attending a conference. It certainly cannot replace face-to-face interaction, but it is darn close!

The webinar is in a league of its own when it comes to convenience. Eliminating travel for education is … you know, I don’t even need to finish that; it speaks for itself.
 

“But, I really enjoy spending time in airport lines,” said no one ever!


And by eliminating travel, you factor in the added convenience of the “anywhere, anytime” mindset. While most MUSE webinar attendees are at their offices, it is possible to attend from any location. Seriously, I have hosted many a webinar wearing … well, I am not going to divulge that. But, let’s just say not business attire – all while sitting in my own home office (or while travelling, or on vacation, etc.). And I am sure some of you have participated in webinars clad in less than your best as well.
 

Casual Friday has a whole new meaning with webinars!


And then there’s the timeliness benefit. Do you like to learn about someone’s upgrade experience as soon as it happens, or long after it occurred? Ok, that’s rhetorical, but it makes the point. Webinars allow for instant sharing of experiences and information. While it’s great to offer sessions at live events and such, it’s even better to be able to relay the details while they’re fresh.

But, what about the affordability? While it’s not exactly apples to apples, the average cost to attend a two-day conference could range between $400 and $2,000 (depending on travel expenses). Studies show that most conference-goers are looking for information on one specific topic, so essentially one presentation is the purpose. A MUSE webinar is $100, and many people can attend if you utilize a projector and speakerphone. Although if you have a webinar subscription the per webinar cost is much lower. MUSE offered 30 webinars in 2012, so with a typical subscription, about $43 per webinar (for as many attendees as you want). And sometimes webinars are free.

So if you have not experienced the immediate and affordable convenience of a MUSE webinar yet, now is the time.

While new webinars are always being added to the schedule, the current upcoming topics are:

  • The ARRA Project: The Quest to Attest Utilizing Project Management Tools
  • Physician Engagement
  • The Patient Experience: An Integrated Process for Complaints/Grievances
  • Project Management Methodology
  • Oncology JAM Session
  • OM/EMR for 6.x JAM Session

And be sure to check out the subscription option for your organization that allows an unlimited number of people to attend an unlimited number of webinars.

All webinar information can be accessed here: MUSE Webinars.

I hope you will take advantage of the webinar program, one of your most valuable resources as a MUSE member. But, if you have questions, or still want more information I look forward to hearing from you.

What do you think of webinars? You can post your answer in the comments.

 
Take care friends,
 




 

Subscribe to the MUSE Matters Blog and head on back for the next post … The 5.66 Upgrade, After the Go-Live – in real time from Henry Mayo Newhall Memorial Hospital.

 

Tuesday, July 2, 2013

The 5.66 Go-Live - the Canary in the Coalmine


Henry Mayo Newhall Memorial Hospital
MEDITECH 5.66 Upgrade Journal
 
 
Guest Poster:
Adnan Hamid, Director, IT Services
Henry Mayo Newhall Memorial Hospital, Valencia, CA

 
 
 
At the International MUSE Conference, I facilitated an education session on my hospital’s experience as a C/S 5.66 early adopter.  With the delay of MU certification for 5.66, our go-live was scheduled after the session for Tuesday, June 18.  I promised the attendees in the session that I would chronicle our experiences with the upgrade and share via the MUSE website. In this article, you will find major upgrade activities along with approximate start times. I have also included any of the major issues we experienced during the upgrade.

We planned for a 12-hour downtime given our previous history with upgrades and the uncertainty of being the early adopter.  As early adopters, we requested to have MEDITECH staff onsite to assist with any issues.  MEDITECH sent us three staff members.  An Update Programmer Manager, Update Specialist Supervisor, and our HCIS Coordinator.  Their presence and ability to communicate with MEDITECH during the upgrade was a critical success factor. 

We delayed the start of the upgrade by two hours due to a full Emergency Room. We started the upgrade at 3:00 am PDT. MEDITECH completed the upgrade by 6:35 am.  At this point, our hospital validate team began reviewing each module for basic functionality and access.  We completed our validation at 8:00 am and planned to lift the downtime flags at 8:30 am allowing our Admission team to register the remaining patients that came through our doors during the downtime. 
 

Shortly after 8:30 am, we started getting calls from users that the system was extremely slow and in some cases would not allow to enter their login information.  We were able to replicate this issue in our command center and show to the MEDITECH staff onsite.  Quickly, the MEDITECH staff were on the phone with the Technical team at MEDITECH. They were able to diagnose the problem to the MIS server running two instances of the CSMagic.exe file. Once they were able to remove one instance, we began to see stability in the system. For caution sake, we decided to allow our users by departments to monitor system stability. This process took about two hours and by 12:30 pm, we were confident to allow all users back to the system. 

For the rest of the day, we did get calls from users about unusual menu freezes and not able to access certain routines.  In all cases, we were able to resolve the issue by uninstalling and reinstalling the MEDITECH Client on their workstation. We kept the command center open until 11:00 pm the same day. Towards the end, we did experience brief outages with FS applications (EMR, PCS, EDM) due to issues with HUB Proxy Server. We continue to see random outages since the upgrade. MEDITECH is well aware of the issue and working on installing code on the Proxy Server to fix the issue. 

Overall, the upgrade was a success!  This was truly a TEAM effort by hospital and MEDITECH team members. While we could not have predicted the duration of the outage and subsequent issues, the time spent on planning for support and preparing our users for downtime were the primary reasons for our success.  I hope that you find this article helpful in your planning efforts.  If you have any additional questions, please feel free to contact me at hamidae@henrymayo.com


 

DATE

TIME (PDT)

Upgrade  Activity

Comments

6/11

9:00 AM

Completed PP#2 Validation Testing; ensure testing in Citrix environment


6/11

3:30 PM

Go/No Go Decision


6/14

5:00 PM

Finalized Support Schedule for Upgrade

Expanded staff schedules to cover 12 hr shifts

6/17

8:53 AM

The UPT application reconciliation report and all worklist items

Even though MT asks to close UPT 3 business days in advance; waited until the day before to add RXM dTS

6/17

11 AM

MEDITECH Upgrade Status Meeting;

Meeting with Core Teams, Hospital Management to review timeline and open issues; final go/no-go for upgrade

6/17

11:50 AM

Received Go from Hospital Team


6/17

12:02

MEDITECH starts pre-Live process. MEDITECH move the code from TEST in a renamed status to the current LIVE ring, because the code is renamed it will not affect the LIVE ring. Once Pre-LIVE is complete, MEDITECH will NOT move changes to LIVE or translate code until after the update is complete.

Do not retranslate custom reports, menus and rules.

Do not refile the EDM Tracker/Access dictionaries in LIVE after the Pre-LIVE is complete, if they are refiled they will crash and cannot be corrected till after the Go Live is complete.


6/17

12:40

MEDITECH Pre-Live process is complete


6/17

3 PM

Completed client update for workstations in non-clinical areas

Utilize Citrix workstations in Nursing areas

6/17

3:30 PM

Finalized  downtime users

Still able to add downtime users even with downtime flag set

6/17

6 PM

Confirmed Downtime Binders are available on Nursing Units


6/17

11 PM

Open up Upgrade Command Center in IT Trailer #1


6/17

11:30 P

Validated Patient Census Reports


6/18

12 AM

Verified Medical Record number procedure in Place


6/18

12 AM

Printed out all downtime reports

MAR

Patient Census

OR Schedules


6/18

12:09 AM

Called MEDITECH to postpone upgrade until 3 AM due to full Emergency Room


6/18

12:30 A

Completed full system back-up


6/18

3:00 A

Authorized MEDITECH to move forward with upgrade


6/18

3:00 A

MEDITECH Software Support Technician (SST) began the update


6/18

3:05 A

MT proceeded with the Go-LIVE process, FS is also now starting their side

of the update as well.


6/18

3:24 A

The 5.66 FS services are now running and I confirmed EMR sign-on on HMA-PXL01. I will now work on setting up the rest of the CS side and updating the

CSproxyservers.


6/18

3:53 A

The object code rename has finished, we are proceeding with the conversions and replays.


6/18

4:34 A

The CFSs are currently running


6/18

4:41 A

We have encountered an issue with the MIS CFSs. Programming is currently reviewing and we will update once we have more information


6/18

5:20 A

The MIS CFSs have been completed, we are now proceeding with the Replays


6/18

5:30 A

Hospital Validation team reports to the Command Center


6/18

5:34 A

The replays are currently running


6/18

5:43 A

The Replays have now finished, we are now proceeding with updating the LIVE bkgs and restarting LIVE jobs.


6/18

6:28 A

The HUB jobs are up and running and the CSproxy servers are up to date.


6/18

6:35 A

The LIVE update is complete and downtime users have been entered. We are now at restricted signon.


6/18

6:35A – 8:00 A

Hospital Validation team begins checking modules for access, functionality, parameters.  Initially, system very slow and unable to emulate. MEDITECH discovers the following:

There were no parameters set to replay to LIVE for MIS

The MIS CFS's are in a cancelled status. It may be related to the configuration issue reported earlier

The MIS job XI MSG FILR: ERX.XI is running with minutes since; NMI is reviewing


6/18

8:00 A

Validation Team 1st Roll Call; all modules report functional; decide to lift downtime flags by 8:30 AM after last downtime patient entered into the system


6/18

8:30 A

Downtime Flags lifted


6/18

8:57 A

After lifting downflags, all applications are reporting slowness. Users are

experiencing timeouts when trying to log into the system using single signon and then experience delays when trying to navigate the menus. After accessing the applications, all routines are displaying response issues.


6/18

10:42 A

There were two csmagic.exe running on the MIS server. This was terminated and performance has improved. Units are being asked to start using the system gradually and we are continuing to monitor response times. This issue may have been caused from refiling the permissions on HMA-FS1


6/18

10:45 – 12:30 P

Gradually allowing users onto the system starting


6/18

12:30 P

All users back onto the system; no slowness experienced


6/18

1:00 P

Downtime Status Meeting


6/18

1:30 P

Send out master list notification to users


6/18

8:30 P

The MEDITECH HUBSproxy-HMA55_L " service terminate unexpectedly

Caused outage for EMR, PCS,

6/18

8:45 P

Restarted Service


6/18

11:00 P

Close Command Center


6/19

12:00 A

The MEDITECH HUBSproxy-HMA55_L " service terminate unexpectedly

Caused outage for EMR, PCS,

6/19

12:15 a

Restarted Service


6/19

12:27 P

Data Repository Available

According to MEDITECH, Data Repository module and database will also experience a downtime but the timeframe is longer and will be down between 8 to 24 hours


Issues:




Module

Description

Status

TECH

TCP proxy for HUBS Proxy server

Contains a few minor corrections in addition to a new debugging feature that will allow MEDITECH to view any issues that may occur and better identify what those issues may be

PCM

Physician Rounds Report Format


EDM

Setting up default printers for controlled Medication Rx

Closed - users are unable to see the listing of printers and there is no default defined.

PHA

Multiple interface errors coming from your dispensing machines into PHA - Pyxis refills; Invalid Transaction Type errors that are displaying from the Process Interface Errors screen in PHA

CS PHA 10963 will correct this issue

BBK

The codabar units will not scan the expiration date, and the ISBT 128 units are giving a "Max # is 14 digits" message

Reload the system dictionaries in LIVE

SCA

Cannot Transfer scans in SCA from folder

MRM DTS 3175

NMI

Mass amount of ADT messages since 5.66 go LIVE

It looks like the ADT generator urns were reset to 6/14; needed to reset for current date


Good Luck!



Adnan Hamid
Director, IT Services
Henry Mayo Newhall Memorial Hospital, Valencia, CA


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