My Trip to MEDITECH

I just got back from spending the better part of two days at MEDITECH. Even though I have been a MEDITECH CIO for 11 years I had only been to Boston 1 other time. I just don’t feel like I need to talk strategy very often. I also feel guilty tying up executive time for a little 15 hospital chain in Wisconsin.

The MEDITECH campuses are beautiful. I suppose that is in part because founder Neal Pappalardo’s daughter is an interior decorator. There is tasteful art everywhere. My understanding is that MEDITECH has unintentionally done very well with real estate appreciation.

Anyone that states that MEDITECH is a closed system that is difficult to interface to/from is stuck in the 90’s, presumably listening the Spice Girls and using CompuServe on their 486. I have always been able to get the MEDITECH interfaces I need. But, the interoperability efforts they have underway really made me say “wow.” They are clearly adopted emerging standards in a way that they never have before.

We were supposed to go to dinner with the MEDITECH folks last night, but we decided to cancel out in order spend some time working (rarely are our clinical IT leaders in the same place). I felt bad about canceling, but I assumed the MEDITECH execs would appreciate their unexpected free time. Today I asked Howard Messing (President and COO) how he spent his free night instead of schmoozing customers. He told us that he installed a new distribution of Linux on one of his computers. I love that dude.

I asked Howard if I should read a business strategy into that. He told me that they are already running some Linux applications internally and have been playing with it. I don’t suspect there is a Linux option forthcoming for MEDITECH’s HIS customers. But Howard, feel free to take Microsoft out of the equation. We can split the savings 50/50.

17 thoughts on “My Trip to MEDITECH

  1. Meditech is closed and proprietary. Interfaces with other systems can run as high as $10,000. Meditech Magic is solid as a rock and being proprietary and non-Windows based is impervious to viruses and vulnerabilities that will bring the Client/server on its knees. If Meditech comes up with a Linux client (or server) that can be installed on multiple distributions it will have a big competitive advantage (don’t forget BSD 🙂
    Windows and a Medical Information Server that needs 99.99% (or the utopian 100%) uptime are a bad combo.

  2. Meditech probably knows that the handwriting is already on the wall for the shut-out of closed and proprietary software systems. These proprietary products would only be preserved if they can be re-packaged as saleable units (like beans ) for customer integration into more flexible open systems or if these medical proprietaries will commit to develop and market robust web services at a rate that is much faster than they seem inclined to invest in today.

    What saves the proprietaries for now is their keen understanding of salesmanship. But the time will come. Meditech mgt is wise and knows well enough to diversify into real estate holdings (and a Linux box).

    Note that some medical practice management system marketers have already felt the intense heat of the open systems dragon. Just search the net for medical open
    or “free” systems practice mgt software and trace the end-user comments.

    Don’t let any standards making bodies lull us into complacency with overly excessive EHR and EMR pontificating. History has an example — the American auto industry’s X.12 standards and bisync to async communications mandates for vendors spawned a proprietary industry that nearly died because the focus was wrong.

  3. Anonymous #2, I don’t agree. Proprietary and closed systems have been given the scholarly and trade cold shoulder for years. Yet, the vendor who delivers the goods, is financially solvent and has intelligent plans is still the one to beat. Meditech “should” have fallen off the map years ago, yet they continue to deliver with proprietary systems.

  4. Meditech told us the same thing in early 2005,(when we were looking at their system). We told them of our concern over rising MicroSoft costs and they told us they were looking at migrating to Linux. Sounds like the same thing happened to you. Guess they are still working on it. I hope they aren’t waiting for Mr. Messing to get it to production?

  5. Meditech is about to port to Linux. I am sure that customers are sick and tired of paying for a Windows server, that only gets to present the hardware to OSAL. Windows basically have no other purpose on a Meditech Magic system. Linux when used can provide the same hardware presentation to OSAL. Then OSAL presents the hardware to Magic and that is the reason a front line operating system is even in the play.

  6. The MEDITECH credo has always been “spend less on hardware and more on software.” You can bet that all of the newest applications written with the newest technology will be nimble enough to run in more than one environment and will require less of an investment in hardware (and its associated support and management costs).

    When it comes to technology and the careful consideration of what’s likely to come flying in the face of its customers for the next 10+ years, MEDITECH does their homework.

    As long as the the “Axis of Intelligence” (Pappalardo, Anschuetz & Messing) is behind the newest development model (i.e. v6.0), you can bet that it will be designed to put their customers (CIOs in particular) in a strategically advantageous position for years to come.

    When you don’t have to bow to the quarterly earnings pressures that public companies face and you’ve got a corporate real estate portfolio that works for you like a cash machine, it can give a company that luxury to slow down, think it through and do it right.

    No company’s offerings are perfect, but MEDITECH customers have it better than most and will continue to have it that way for the unforeseeable future.

  7. Hello, I am a Board member of a midsize regional hospital in the southwest and have been thrust into the position of chair of our IT Committee. MEDITECH seems like a ridiculously backward system (not Windows based, cannot use mouse or tablet PCs) and I am struggling with why we should continue to use it, especially since true compatibility with other non-MEDITECH modules seems to be a real issue in practice. Comments on this page seem to differ with that perception; are all of you confirmed MEDITECH CIO’s? Would appreciate some frank input to help me with “attacks” from docs at our facility that absolutely HATE MEDITECH and refuse to use it because of its unfriendly, unintuitive, MS-DOS-based nature. Thanks.

    • I am a pregrad nursing student at York University, City of Toronto. Currently I have my clinical rotation in the hospital still using DOS-based Meditech.

      Before I went back to school, I was a systems administrator in Moscow branch of GE Money Bank (I am a Microsoft Certified Systems Administrator). Thus I can see the situation from both points of view: from the IT guy perspective and from the healthcare worker perspective.

      Many IT guys see legacy DOS-based versions of Meditech as a cheap, stable, rock-solid software. If they need, they can pretty easily customize it, adding new modules for the ICU or for the coronary care unit. Therefore, you may never convince them to switch to something else. They don’t care that somebody may struggle with the system that DOES NOT have intuitive understood graphical interface.

      Healthcare workers who have sharp visual memory also don’t care: they can memorize numerous key combinations and start taking advantage, navigating and charting quickly. In my unit I often witness how these “fast” nurses verbally abuse “slow” colleagues who CANNOT memorize Meditech hot keys (therefore, these “slow” nurses have troubles charting).

      Therefore, the use of DOS-based Meditech is not just time-consuming headache. In my opinion, potentially it is a base for abuse and bullying within any interdisciplinary team given that in many hospitals and units pretty bullying culture of nursing already exists (Leer, 2006).

      That is what I think.

      * Leer, R. (2006). Effective nursing management: a solution for nurses’ job dissatisfaction, and low retention rate?. Retrieved from CINAHL database.

      • Of course MEDITECH is not DOS-based. It would be more accurate to say it is character-based. But that technical point is trivial to the commenter’s more important point regarding usability.

        • Yes, you are right – it is character-based. “DOS-based” is just a common cliche. But the main point is lack of graphical interface, lack of any copy-paste and other editing options.

          Many nurses in the unit where I currently work have to stay in the unit long time after every shift to finish charting. Of course, it is mainly a result of their high workload but MediTech also contributes to the issue.

  8. I’m a level 2 tech at a midsize regional hospital in Kalispell, MT. We have been looking at several ways to get meditech out of the office stranglehold. Would be really nice if Meditech would 1) port to another O/S, 2) even just make it so that it would work with Openoffice instead of being so office clingy…

    Anyway, my 2 cents.

  9. Hello,

    We are going to be initiating a relationship with another hospital who will be hosting Meditech for us, which we will access using the UPD based client across a VPN tunnel. My concern is that they are telling us that the connection with them cannot be firewalled or filtered in any way. I have a hard time believing that the client requires all 131070 combined TCP and UDP port open for the client to function. Any thoughts?

  10. We are a small regional hospital (139 bed) in Ohio, and we don’t ever feel guilty about taking Meditech time 😉

    I would love to see Mediteh open their standards a bit more. $15,000 + for simple HL7 interfaces with other clinical systems is a bit pricey and often causes us to negate the interface if we can’t do it through a secondary vendor. Meditech is Rock-solid, in the MAGIC environment, but the moves by Microsoft with licensing models and product lines has us looking for a different client O/S. I would love to see a Meditech front-end client for MAGIC that operates on Linux or another OS. Would also like to see different options for virtualization, etc. with Meditech. Disaster recovery is another sore spot…

    For someone smaller, Meditech is a solid option but very expensive to support/maintain. We are seriously having to look at hosting options, but the companies out there providing them are $$ too. We’re also stuck with the future outlook of moving to C/S when the current range of MAGIC upgrades expires…

    Overall, Meditech works, and works well, though innovation is a bit behind the times. We won’t be looking to change for quite some time, but would love to see some shifts there in their development areas…

    As towards myself, I am the Network Administrator, not CIO, so I am the one who leads the team that makes it all work. I’ve been using/working with Meditech for over 7 years now in a Windows based Magic environment.

  11. We are told that new Meditec upgrade will require close UDP and use TCP, and we have some 3rd party vendor using UDP to download interface, does any of you has any advice on this?

  12. I must be listening to the Spice Girls or something. I am trying to rewrite our ADT interface to MediTech and I’m finding that replicating transactions and sending multiple transactions for every stinking A08 is crazy. If it’s an A08 with patient type E, you have to send them an A11, A08, and an A04? Give me a break. This is straight from their specs. Pt arrives in the ER, gets two revise transactions and a departure (4 HL7 messages) and I have to send Meditech A04, A11, A08, A04, A11, A08, A04, A03. Crazy. I’ve been building HL7 interfaces for 10 years. This the strangest setup I’ve come across for ADT.

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