Single Sign-On and Content Sharing Between Applications
November 24, 2020 Written By: Ken Hoffman, President/Owner
Single Sign-On (SSO) is not the entire answer to clinical efficiencies but rather one important piece of the puzzle. There is no doubt SSO enabled software has allowed users to become more efficient, but the missing piece of the puzzle is clinical content sharing between applications. Clinical content, like what patient you’re on in the EMR, what clinical application you’re in, what user is logged into the workstations, what user is logged into the EMR, etc., are key pieces to the efficiency puzzle. Most clinical EMR software supports some level of FHIR API’s calls which have added much to the missing clinical content piece of efficiency, but it doesn’t solve the entire workflow challenge.
The missing piece of the puzzle is integrating other clinical software into the clinical EMR workflow with clinical and other content. Several specific challenges exist with content sharing, like is the user logged into the EMR the same as the user logged into the workstation? When launching other clinical applications from the EMR your SSO and content software must know who’s logged in to the EMR and who’s logged into the workstation. In the case of multi-user workstations, you want to know what EMR user is launching into the other clinical software. Another challenge is using Health Information Exchange (HIE) or other collaborative content sites and the delay to compile them when needed. For instance, you might want to precompile HIE or collaborative content when the user is on a specific screen so when they need it the content is immediately available, no need to wait while it compiles.
One way in which this efficiency has been achieved is through the use of LaunchIT. HCI’s LaunchIT application is designed to meet all the clinical content challenges without complicated, fragile software design. If you have clinical software you want to integrate with your clinical EMR workflow with SSO and content, LaunchIT is what you’re looking for. Powerful, solid architecture to meet all your clinical software integration needs.
Click here to learn more about how you can optimize your workflow with LaunchIT.
Contact Us to schedule a demo and see LaunchIT in action.
September 30, 2020 Written By: Dan Collins, VP of Operations
What is this term “Data Definition” that everyone is always talking about? Okay, I admit maybe not everyone is talking about data definitions, but it is a common term thrown around for us folks that work in the MEDITECH space. Especially for those involved with requesting, designing, or creating reports.
A Data Definition is MEDITECH’s Term for a Data Schema.
Simply put a data definition or data schema is just a description of how data is organized and stored in a database. The terms data definition and data schema refer to the same thing. Data Definitions and data schemas are like words in a dictionary. Every field or key in a database has a definition. Except in this case, instead of a description of what the word means the definition describes in technical terms how the field is organized in a database and what its attributes are.
Keys, Records, Fields, and Attributes – Oh My!
A field is simply the smallest element of data in a database. Fields are defined by attributes like name, size, data type, length, and required. Attributes describe the behavior of a field or record. In addition to attributes fields also have values. However, when we are discussing data definitions or data schemas, we are generally referring to the attributes of the fields and what records they belong to, rather than their values. The data definition is created when designing the database and the field and key values are put in place when the database is being used.
A record is simply a group of related fields. For instance, in MEDITECH the RegAcct.Providers record contains fields like IsPrimaryCareProv and IsAttendProv. This record has two keys. The first key is the patient identifier. In MEDITECH the patient identifier is referred to as the OID or Object Identifier. The second key is the Provider, which points to the person dictionary. This would be the physician’s user ID or user mnemonic.
Keys are used to identify a specific instance of a record. To illustrate this concept, think about this simple real-world example: Lets design a database schema to keep track of library books. You might design a record called Book, that contains fields such as: book title, author, publish date, and type of book (paperback, hardcover, digital), ETC. A good key value for the book record may be the book’s ISBN number. It is often the case though that the library will have multiple copies for a particular book. In that case you may want a separate record to track each physical book in the library. The record to track this might be called BookInventory and contains fields like ISBN number (points to the Book record), book status (in/out), and the library user that has the book checked out. The key for this record could be a system generated number that uniquely identifies each physical book in the library.
Why are Data Definitions Important?
Reports are an important part of the modern Electronic Health Record (EHR). The first step in designing any report or SQL query is determining what specific data is needed to meet the report requirements. Then you need to determine where the data is stored in the database. The data definitions are what you need to determine where the data is stored and how it is organized. To add fields to your report, you need to know how the fields are identified (what record keys are needed). There is no way to write a report without understanding the relationships of the fields that are needed for your report. The data definitions clearly spell this out for you.
When working on reports or SQL queries it can be extremely valuable to view data in its raw form. Viewing the data definitions is helpful but looking at the raw data after reviewing the data definitions can really help you understand the relationships between the different fields and records. MEDITECH has a very powerful tool called Object Viewer that can be used to view MEDITECH data in its raw form. However, this tool is only available to MEDITECH staff. For those of you that are familiar with C/S and MAGIC NPR, this is akin to viewing MEDITECH data from the “G” get function at the MEDITECH front end.
We are all bound to protect patient data and should only be allowed to view data that we are granted access to view. It would be extremely useful for folks writing reports to be able to use a data viewer tool that only provides access to the data that the user has permission to view. When working on SQL reports or queries, typically the person writing the report can easily view all the data in the database he/she is working on. Keep in mind though that a MEDITECH SQL database (livefdb, lvendb) contains ALL of the MEDITECH applications for the designated platform (M-AT or NPR). Access to view specific data can be controlled at the table level in SQL. However, often access is granted to an entire database. This type of access does make sense for someone that is writing a report.
Viewing Data Definitions
Fortunately, there are a lot of great tools for viewing data definitions. I put this table together in order to outline all of the different tools that are available and some of their pros and cons.
Data Definition Viewer
MEDITECH’s tool that is built into the MEDITECH system that can be found on the Report Designer Menu. There is also a link to it directly inside Report Designer.
Built right into MEDITECH.
Can be used for either M-AT or NPR applications.
Has a very useful search feature built into it.
Can follow links to other objects on pointer type fields.
Does not allow you to view field values.
The search feature can be slow.
Does not show SQL table or column names.
This tool is also built into the MEDITECH system. It allows you to view the data definitions and the raw data. This is a very powerful,
extremely useful tool for browsing the database and viewing data in the
The most powerful, useful tool for viewing MEDITECH data.
MEDITECH’s SQL Data Repository Database Layout. This tool is very helpful for
browsing/viewing the SQL database layout for DR. However, this tool does not
show you the MEDITECH database layout for the MEDITECH transactional EHR.
View MEDITECH data definitions in the browser.
Quick to navigate.
Can use Ctrl+F to quickly search through data definitions.
Can follow links to other tables for keys and fields that point to other tables.
Includes both M-AT and NPR data schema.
Can download schema data files. Useful for comparing system schemas.
Very useful for SQL but does not include the MEDITCH EHR data definitions.
Microsoft SQL Server Management Studio (SSMS)
This is the Microsoft tool that is used to manage Microsoft SQL Server databases and to write and execute SQL queries. Built into this tool
is the ability to view the database schema.
The most powerful, useful tool for viewing MEDITECH data in an SQL database.
Easy to restrict user access to specific SQL databases. However, all MEDITECH applications are lumped under the same SQL database.
Tables can be very slow to load if you don’t filter them out.
Not easy to restrict user access by MEDITECH application.
Data access is not logged.
For SQL data only.
Click here to view The HCI Solution’s Data Definitions Tool.
The HCI Solution Data Services team also provides advanced report writing and report conversion assistance, Click here to check out our services.
The HCI Solution gives back to the MEDITECH community by providing complimentary beginner to advanced Report Designer Educational Sessions each month. View our upcoming RD Ed Sessions.
August 3, 2020 Written By: Jim Smith, Director of Data Services
In Expanse, MEDITECH provides two full-featured reporting solutions: NPR Report Writer and Report Designer. Whether we are transitioning existing reports from MEDITECH MAGIC or Client/Server (CS) to Expanse, or building new reports within an active Expanse environment, we need to take a granular view of our options and determine which tool is best suited for each use case. In this exposition, we’re going to review the pros and cons of these two tools, and how to leverage these traits when determining the best option for our reporting needs. Though our examples will be focused on reports being updated across platforms, the same considerations are applicable to new reports being created in Expanse. In addition to our evaluation of NPR Report Writer and Report Designer, we will discuss how you can have the best of both worlds.
Those of us writing reports in MAGIC and CS are already familiar with MEDITECH’s NPR Report Writer, and any existing reports will be written in this medium. The NPR Report Writer is a robust, versatile reporting tool with the capacity to write extremely complex reports with relative ease, using the editor’s extended fragment and macro functionality. This functionality lends itself well to staff familiar with the NPR programming language, being able to create powerful macro-driven reports, that can even call other reports or MEDITECH routines, as needed. Though the MAGIC and CS NPR Report Writers have syntactical and platform-specific differences, converting existing NPR reports to Expanse will only require minor adjustments, provided that the application they are written out of, and fields they reference, are still in NPR in Expanse. This brings us to our first hurdle: there is no native way to pull fields from M-AT applications into an NPR Report Writer report. In Expanse, many applications have changed platforms from NPR to M-AT, such as Abstracting (ABS) and Patient Accounting (BAR), and any report needing to reference data from these applications would need to be built using Report Designer.
Report Designer is the report writing tool MEDITECH provided alongside the release of the M-AT platform and it is included with Expanse. Report Designer has a streamlined, user-friendly interface with many efficiencies that simplify the report creation process. For example, Report Designer includes a mode designed specifically for creating export-style reports that can be leveraged to quickly generate reports in multiple formats. Rather than providing free-form macro functionality like NPR Report Writer, Report Designer is integrated with a rules editor that does not require any programming experience to utilize. This rule-based approach is both a pro and a con, for though it allows users with varying degrees of experience to add custom logic to reports, reports written in Report Designer are bounded by the limitations the rules editor imposes. This can make the task of reproducing complex macro-driven NPR Reports in Report Designer challenging, and unfortunately, in some cases impossible.
When faced with the impossible, we were compelled to pose the question: What if there was another option? What if there was a means of retrieving M-AT data, while still benefiting from the power and versatility of NPR Report Writer’s macro-driven functionality?
June 1, 2020 Written By: Pedro Jimenez, Director of Interface Engine Services
Your integration engine is the operations data exchange hub of your facility. Adopting measures to maximize its efficiency and reliability are essential to safeguard the flow of data to your mission-critical applications, and as an indirect consequence, enhance patient safety. One of these measures is the selection of a database management system for use by the integration engine. An integration engine consists mainly of two components: 1) the engine itself and 2) a storage component. This storage component is usually in the form of a database management system. The election of a database management system can make or break the operational efficiency and reliability of these critical dataflows. It is for these reasons we recommend considering a NextGen Connect database upgrade and offer a few things to consider while making that decision.
Reasons to Consider the Switch
While the NextGen Connect (formerly Mirth Connect) integration engine includes the open-source Java-based Apache Derby relational database as part of its small system footprint, Apache Derby is still recommended primarily for use in testing environments and very limited use in production environments, especially where the message data is not stored.
There are several good reasons to consider the switch to other relational database management systems which include: 1) more robust database management systems like Microsoft SQL Server, mySQL, Oracle and PostGreSQL, 2) compatibility with enterprise database backup applications and 3) powerful database management tools like Microsoft SQL Server Management Studio, NaviCat and PgAdmin.
The Benefits of More Robust Database Management Systems
Examples include: Microsoft SQL Server, mySQL, Oracle and PostGreSQL. These relational database management applications have established track records for being the backbone of enterprise data. They are known for their reliability, speed, efficiency, versatility, and control of database size growth; all of these traits are critical to the high transaction environments in which integration engines are employed.
Compatibility with Enterprise Database Backup Applications
Enterprise database backup applications are designed to create incremental or single snapshot backups of data stored in these systems. A well-run information technology operation includes scheduled datastore backups as part of daily operations. There are software solutions offered by the database management system manufacturer or by third-party vendors that address this need. Having a database management system that can readily integrate with these enterprise backup solutions can make the job of safeguarding stored data much easier and more cost-effective.
Powerful Database Management Utilities
These utilities provide a user interface that allows database administrators to manage and control how data is handled by the database management system. While there are several database front-end client tools available for Apache Derby, there is a greater number of applications offered by the database manufacturers and third-party vendors offering more comprehensive features. For example: Workbench and NaviCat for MySQL, Management Studio for Microsoft SQL Server, and PgAdmin for PostGreSQL provide graphical user interface tools that allow users to access and manage the data contained within these databases. Most of these examples have been regarded as industry-standard tools for decades.
The good news is not only does NextGen Connect support MySQL, SQL Server, Oracle and PostGreSQL, but it is also extremely easy to migrate to other database management systems at any time, even after Nextgen Connect installation. With some basic planning (and practice on a virtual machine to ensure success), migration to a new database system can be safe, easy, and worry-free.
Pedro Jimenez, The HCI Solution’s Director of Interface Engine Services, explains the planning and execution of the database switching process in a step-by-step video titled Upgrading the Database in Mirth®/ NextGen®Connect which is part of the “Interface Engine How-To Series” multi-part video training series. You can watch this fourth installment by clicking here.
May 1, 2020 Written By: Samantha Cameron, Business Manager
During these difficult times we have seen a rise in traditional office goers working from home in an effort to “flatten the curve”. Working from home can be challenging, especially in an uncontrolled environment that may include stir-crazy kids, significant others, and/or pets that aren’t used to you being home 24/7. Working remotely takes great discipline and organization to be successful and productive, but it is achievable. The HCI Solution was ahead of the working from home trend with 100% remote employees from the start of our incorporation. Because of the current COVID-19 pandemic, working remotely has quickly become the “new normal” so we felt inspired to offer these 7 ways to limit the work from home struggle.
1) Designate your office space
If you don’t have an office try to designate a quiet area with minimal distractions and traffic as your “office”. Communicate to other members of your household that this is where you’ll be working and to try and avoid that area if possible.
2) Keep regular working hours
Yes you are working from home, and working from home offers more flexibility in many ways. However, sticking to a daily schedule and setting normal work hours not only helps you but also your family. If they know you are working 8-4 or 9-5 then they know when to expect you. This way you also know you’re putting in the hours your workplace requires.
3) Set rules and boundaries
Once you have your office space and hours established make sure to communicate your plan to the other members of your household and set necessary boundaries. Explain to them that noise should be limited in that area during those times.
4) Stick to a daily routine
Obviously, parts of your daily routine have changed if you’ve transitioned from office to home. However, sticking to a routine as close to your normal routine as possible will help, especially if/when the time comes to head back into the office. Whether you start your day with coffee, a shower, whatever it may be; continue to start your days the same way as before. You might use what would normally be your drive time to do things around the house so you aren’t distracted during the day or offer that time to your family and/or pets so they are less likely to interrupt while you are working.
5) Stretch regularly throughout your day
Even if you normally work a desk job, when working from home you are less active than you would be if you were going into the office. Try to stretch periodically throughout the day to invigorate and refocus while also preventing soreness from sitting too long.
6) Invest in your technology and know how to use it
You may not have much say in the equipment that is provided to you but one item we highly recommend investing in is a quality headset. One that limits background noise and has a muting option. We use phone conferencing with screen share and having high quality head sets helps tremendously. Also, make sure you familiarize yourself with the technology you’re using. Prepare for meetings early and make sure everything is functioning properly and that you know how to use the tools at your disposal.
7) Keep it clean
Last but certainly not least, keep it clean! Good hygiene is about more than just who sees or smells you, it’s about being healthy and just feeling better all around. Also, keep your workspace clean and clutter free. Organization is key to working from home and if you have a cluttered desk it can be a major distraction.
We’ve all had the worries of noisy family in the background and distractions while working remotely. These things are going to happen at times. No one knows exactly what the future holds, but if we had to guess, remote jobs are only going to increase in popularity and we truly believe by following the 7 tips provided, you too can be successful in a work from home environment.