What Providers Don’t Know About ICD-10 Might Hurt Everyone

With ICD-10 coming in just over a year, it’s going to be important for organizations to determine the best way to minimize the impact to providers. Most people understand that with the transition to ICD-10 comes a drop in productivity for billers, coders and providers. However, documenting correctly the first time around can save providers time by minimizing the need for queries, which in turn allows for faster payment of claims. Given this theory, there are a couple of things that organizations can do to prepare:

  • Run reports to determine top diagnoses by specialty and/or to determine high impact diagnoses
  • Review the ICD10 requirements for the diagnoses listed above
  • Review existing EHR templates for documentation that supports ICD-10 coding as it relates to those top diagnoses.
    • Option 1: Color code ICD-10 requirements (on condition specific EMR templates, if possible) so that providers know exactly what the minimum requirements are. Also, add in missing requirements (where reasonable).
    • Option 2: Remove any checkboxes/radio buttons that don’t support ICD-10 coding. Also, add in missing requirements (where reasonable).
  • Allow a section or multiple sections where providers can use voice-recognition software or free text to tell a complete story about the patient.

Understand however that these recommendations do not negate the need for all other discreet data as it relates to Meaningful Use (MU). Be sure to inform providers that although Clinical Documentation Improvement is the focus (CDI), Meaningful Use still applies and appropriate actions need to be taken to meet those requirements as well.

It is possible that many organizations don’t have the resources or the time to take action as recommended above. It’s also very easy to say that all the required information lives somewhere amongst the “templates”. Sound familiar? The bigger question is…can the providers find it? Given that troublesome thought, making the time and devoting one or more resources to clinical documentation improvement could net the organization in short and long term gains.



Considerations when implementing Imagelink

co-author: Ryan Hunt

imagelink button

One of my clients recently implemented Imagelink for the Allscripts TouchWorksTM EHR application, and I would like to take this opportunity to outline some of the customizations required in order to meet expectations and policies set forth by the client. For those who are not familiar with Imagelink, it is an Allscripts add-on used to bridge a connection from the EHR to a PACS (Picture Archiving and Communication System) by passing a dynamic URL to the end-user that is populated through an inbound interface.

Imagelink will help your organization meet meaningful use (MU) as CMS established the MU menu #3 measure for stage 2 as “more than 10% of all tests whose result is one or more images ordered by the by the eligible professional during the EHR reporting period are accessible through the certified EHR technology.” Not only will it help you meet this measure, but it will also improve the process for your providers as they can then view imaging results in their primary EHR application without having to jump into another application

Some of the customizations and lessons learned by my client include:

  • Testing:
    Part of testing should include all data that is sent thru the configured interface. Since enabling Imagelink requires a few edits to the parameters of the FileResult_CMS call, we want to make sure no other parts of the results are affected.  During initial testing we found that the written report was being overwritten by the execution of the additional mapping.
  • Image Viewer:
    Be aware that the additional window that opens to view the Image will remain open even if one user logs out and another logs in. The user will also need to remember to close the window so that when they go to another patient record they are not confusing the Image with the next patient. The use of single sign on may make this a moot point.
  • Timeout:
    In order to improve security the client required that the URL become unusable after a set amount of time. This required a timestamp to be sent in the URL outbound from the EHR to the PACS. This particular timestamp is generated from the server natively and is sent in Epoch Time. The format needed to be altered in order for the PACs system to recognize the timestamp.
  • Encryption:
    A custom javascript file was written to take in the variables generated from the URL and encrypt them. Once the string was encrypted we utilized a .html file to launch the fully encrypted URL which made the image available to the end user.
  • User Configuration:
    In order for a user in the TouchWorksTM EHR application to be able to use Imagelink, we created a connection for each and every user to the “StentorImagelink” application. See screenshot (TWAdmin >> Users):

A demonstration of Imagelink provided by Galen Healthcare is available here.

For further information or technical assistance with implementing Imagelink at your organization, please feel free to contact us.

Monthly Webcast Roundup – August 2014


This past month, Galen presented the following webcasts:

11.4 and MU2 – Recommended 11.4 preference settings for MU2 attestation.

HL7 FundamentalsThis webcast is an introduction to HL7. We will cover the background of HL7, the basic format of messages, the most common message types and data exchange standards.

Task Analytics and OptimizationJoin us to see how Galen’s Task analytics can expose inefficiencies in your tasking workflows, and let our subject matter experts share Task configuration tips and tricks to help your organization operate with greater productivity.

Advanced HL7: CDA/CCDThis webcast will provide an overview of CDA/CCD Data types, Sections, Entries, and it’s role in Meaningful Use.

The links above will take you to the slide deck and Q&A of each webcast.  If you missed a webcast, or are interested in re-watching one, contact us at sales@galenhealthcare.com to obtain a link to the webcast recording.

You can also contact us to discuss how Galen can assist your organization with any of the services you saw on the webcast.

Upcoming Webcasts – September 2014


Be sure to register for these upcoming webcasts during the month of September:

September 5thTouchWorks EHR System Optimization: Understanding the importance of doing a system optimization after go-live.

September 10thAllscripts Common Interface Engine (Rhapsody) Error Resolution with the Reconciler: Join us to for an overview of what interface error resolution will look like and how it works once you make the switch to the Allscripts Common Interface Engine.

September 19thOrder Changes with 11.4.1: Review of lab, imaging, patient education and referral order changes in 11.4.1 as designed to facilitate usability and order adoption for MU2.

September 24thGalen Products Overview: Join Galen’s Product Team to learn more about our current TouchWorks add-on applications to improve user productivity. We will review the following products:-eCalcs: Integrated Health Calculators-VitalCenter: Business Continuity Solution-Dragonfly: Remote Patient Monitoring

Click here for a list of all upcoming webcasts. If you are interested in viewing any past webcasts, please reach out to sales@galenhealthcare.com for a link to the recording.

Modern Healthcare “Best Places To Work”

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I was not at home when the flower shop called to tell me that they had left a delivery in the breezeway.  I arrived to find a beautiful arrangement, but it was the card that exemplifies the tone of our daily life here at Galen Healthcare Solutions.  “Galen Is One Of The Top 100 Best Places to Work In Healthcare-Modern Healthcare 2013-2014.  Thank You for Making Galen a Great Place to Work.”

The Modern Healthcare Survey asks employees detailed questions around eight core areas of Leadership and Planning, Culture and Communications, Role Satisfaction, Work Environment, Relationship with Supervisor, Training and Development, Pay and Benefits, as well as Overall Satisfaction.  Some companies would take that feedback and file it away, but not Galen.  Our leadership takes that feedback directly into employee forums, and then creates action plans to achieve goals.  This transparent approach is a good example of what happens on daily basis at Galen.

As a client you may ask, “Why should I care that a consulting organization made it onto this list?”

With all of the seemingly impossible timelines for competing objectives like Meaningful Use, ICD-10, ACO’s, changing payment models, and interoperability it is vital, possibly even critical, to hire the right partner.  This achievement means that Galen is set apart from other firms in the industry.  We attract the best talent and more importantly have the healthy atmosphere to retain that talent.  This positive environment allows our consultants to completely focus their attention on clients.

Galen’s cornerstone value to Perpetually Learn and Share attracts many of us committed to sharing our knowledge.  We invest in each other and our clients every day.  We achieve giving back to the healthcare community through regular webcasts, blogs , as well as our public wiki.

When you hire one Galen consultant did you know that you are actually hiring all of us?  Our unique system of communication makes us ambassadors of collaboration for both the Technical Services and Professional Services aspects of project management, implementation, training, as well as custom application solutions and development.

The flowers I received will eventually fade away, but the card is taped to the computer screen as reminder that Galen Healthcare Solutions epitomizes PRIDE in everything we do from our internal employees to all of our clients.

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