Sage Memorial Hospital Trusts Healthcare Triangle for its MEDITECH-as-a-Service (MaaS) Implementation

The Client

Sage Memorial serves as the sole provider of healthcare services for a community of approximately 23,000 people, treating patients with a complex payor mix and list of insurance coverages and programs that range from Medicare/Medicaid, IHS and Commercial. Today, the Navajo Health Foundation – Sage Memorial Hospital operates the 25-bed hospital as well as ambulatory, dental and field clinics.

The Challenge

For decades, Sage utilized the MEDITECH MAGIC platform, but their configuration of MAGIC resulted in gaps in integration and reliance on paper and hybrid workflows. Leadership began a search for a new system. The MEDITECH MaaS Platform offered an efficient implementation and cost-effective pricing on a modern technology platform. Being 20+ years away from their last EHR implementation, Sage Memorial faced a steep learning curve to adopting this new technology.

They faced core challenges including:

  • A large discrepancy in features and functionality between Sage’s Legacy MEDITECH version and the new functionality of MaaS
  • Lack of implementation knowledge such as project term definitions, nomenclature, and expectations
  • Limited resourcing, including staff time to research, learn, make decisions, and roll out project needs within the project timeline
  • Lack of understanding of the options available for critical areas. Sage needed to either find a way to leverage the standard delivery of the MaaS solution or adopt a modified approach, and they needed guidance to truly understand what would work best for their situation

The Needs

The business needs of Sage are highlighted below:

  • New Technology: Many processes were still manual due to the limitation of their MAGIC system configuration. Sage needed a new EHR to meet the current healthcare requirements (i.e., electronic health documentation) and redesign/build processes to replace ingrained, fragmented manual processes
  • More Complete Patient Documentation: Sage used to book patient appointments manually on notebooks and without an appointment booking system in place. They needed to make managing pre-registration more accurate and less cumbersome
  • Patient Accounting Automation: Sage previously used the paper claim programs (UB92 & 1500) for its billing through the clearinghouse to insurances. Due to this, Sage’s billers had to manually fix many of the claims before they could be accepted for claim submission. Sage required experienced implementation resources to guide departmental build and process decision[1]making, including coordination of financial processes such as electronic claims
  • Template for New Services/ Offerings: Sage wanted to implement a system to support future strategic initiatives, such as re-establishing surgical services and leveraging the new EHR to capture discrete data and more easily report on regulatory requirements
  • Platform and Vendor Knowledge/Expertise: Sage wanted to ensure effective communication with the vendor and proper/appropriate utilization of the MaaS EHR Platform

The Work

Some of the key highlights of HCTI’s work for Sage include:

  • HCTI consultants worked to bridge communications for Sage and MEDITECH staff in understanding each other’s needs and requirements. HCTI also provided guidance for the Sage team to focus on implementing the features best suited for their needs
  • HCTI guided the implementation of the electronic 837 claim format. HCTI led the effort in coordinating between the Sage team, MEDITECH, and the claims clearinghouse so that claim data could flow smoothly from one system to another
  • HCTI assisted Sage in setting up and optimizing worklist functionality, replacing paper reports previously required to manage and track daily work
  • HCTI worked closely with MEDITECH to set up and demonstrate the optimum workflow in MaaS, and Sage is now using CWS for all their clinic appointments. More importantly, patient care is done electronically throughout the scheduling, provider documentation, and the discharge process – all in one cohesive workflow
  • HCTI provided experience and expert guidance to support Sage and MEDITECH in the design and build of workflows for current and future initiatives
  • Strong, dedicated resources with Expanse/MaaS best practice implementation experience targeted for critical access hospital organizations were provided
  • HCTI provided a flexible plan with experienced consultants who could fill in the gaps where the client could not provide the required level of engagement


Sage Memorial had a successful and on-time Go-Live of its MaaS EHR Platform. Users continue to learn and gain comfort with the new workflows and take advantage of the efficiencies. Some of the key results achieved by Sage include:

    • More complete, accurate, and robust data and reporting
    • The successful transition from paper and free-text notes for nursing staff, enabling structured data assessments and electronic care planning. HCTI continues to assist with optimization, streamlining build and nursing workflows
    • Ambulatory clinical build focused on efficiencies in documentation per specialty helping to automate billing, improve documentation and regulatory reporting requirements
    • Electronic surgical services configuration allowing for an easier operational implementation when Sage begins providing surgical care


  • With HCTI team’s expertise and dedication, Sage went live on time, successfully transitioning multiple paper workflows. Sage continues to rely on HCTI’s expertise to improve their use of the system to its full potential
  • With the guidance of HCTI experienced consultants Sage took advantage of system functionality to automate key processes saving time and money
  • By leveraging the new electronic processes such as automated supply chain management, improved document and record management, centralized scheduling, CPOE, and documentation, Sage can access data and reporting that was not previously available.

Reasons for choosing HCTI

HCTI’s partnership with the client led to understanding Sage’s specific business objectives and establishing trust. This allowed HCTI to offer targeted resources/support and a flexible delivery model that didn’t lock them into long-term contracts or “minimums” to meet their needs and project timeline. HCTI also offered:

  • Expertise and experience with Expanse/MaaS software, industry best practices, and implementation methodology
  • A strong understanding of project priorities and terminology
  • Experience with IHS unique requirements for documentation and billing
  • Resources with experience in the MAGIC platform and conversion to Expanse/MaaS
  • The trust that HCTI would truly help them for a great price

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Sage Memorial Hospital





…HCTI was
‘very cost-effective’
compared to
other options

Coronel Lopez

Sage Project Manager

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